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~~- ~Vatice of State Tax Lien nehrask:e depertmen; .,r re~,en:,r. s Read irtstructiom on reverse side Lien Serial Number County Date SpClal Security Number 9/1IJ849 Hall 111-26-79 I 506-70-3348 ~ 79~ ~'i Nebraska 1.0. Number en Type Lien FileO With SPOUSe'S SOCIa+ Sec Jrity ~Originai ~(~ Registe+of OMtl5 Number pay 3482022 ~ i ;~ Renewal 1 ~; CoUntY Clerk BUSMESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS Business Name ~ Name r tru i n Street Atltl•ess Streef or O her Maiilnq Atltlress 70 ac 7 7 b r City State Zip Cotle City St a te ZP Cooe ~~~~~,.t ~HSd12LL ~ p pp~ _52404_.7.._.. _ _ - Pursuant to the revenue laws of the State of Nebraska, notice is hereby given that taxes (including penalties, interest and additions} have been assessed and are due from the above taxpayer and remain unpaid after demand. These taxes constitute a lien upon property in the county belonging to the taxpayer or hereafter acquved. Liens for sales and use taxes only attach to the real property of the taxpayer located within the county or hereafter acquired, Tax . ~~ ~ Tax Period Date of f - i ~ ~ Balanw of Assessnurit Arrrouni of Tax Penalty ~ lotarest Additiota + ~~~t ~ 1 17-1-79 tilru 21 f4-30-79 ~ ~ ;11/26/79 138.66 ~ 6.93 i .69 i ~_ 146.28 ' ~~ ~ ._ I I i j' ~ j i I ~' 1 ~ - 1 ~ ~ ~ ~ i ~ T ~ i i 1 ~ i ~ ~ ~ __--- _.` -- TOTAI iS 14fi.~R _ t nerebr certiiv inat ine Nebraska Oapartment of Revenue nas comPiieC with tna revenue Eaws ai tha 6'~t*te of Nebraska En ±he oeter- menatsan cf the amsrnt s^ew': 20 be Cue. a.^.C t.^.t tax,ave+ naS' tasted t© ca. t^x a^=cu.^.t tlue attar Cs^eantl, fE !A;.ls Natece of State Tax Llrn is an ex tensirtn of an ettactiye lien it Serves tp iOnt~n~e t,'te Prig={y. pt the S'ate's interest to :ne atfecteC prupePEy >;rt the taxpayer. -here- Special Agent 1i-26-79 Authorizeo Sig ure Title Date FOR COUNTY OFFICIAL'S USE