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u+~~~r'oJUS -- <br />PURPOSE OF FOAM. This Form -is to be-used by the Nebraska - <br />Departmenx of Revenue-tor the purpose ~f rtot~'ying rite appropriate <br />county authorities that a Xiotice tit State Tax Lien is being filed <br />against [he taxpayer indicated on this forrrt. - _ - _ <br />The. tax caxegory number code5`artd~he-ldebraska~ax-programs they.. .. - - <br />represent are listed below. <br />_ Ql'° ..' .......... . ........... . . .:Sales Tax. <br />02 .........................Retailers Use Tax <br />04 ...:...... : ...:...:... Gonsutners-Use Tax" _ - , ,: <br />lo ............................Parrmutuel <br />46" .........:............ _..... Estate Tax - <br />21 , ..... .:.............Income Tax Withholding <br />- _ 22 ..................... IndividuallncomeTax -.. .:. - -: .-- -.. - <br />23 .. . ... . ....... . . . ... _Fiduciazy Income Tax <br />Z4 , ::.........Corporate Income and Franchise.-Tax <br />- 44 .............Mechanical Amusement Device Tax - - - - - <br />36 ...........:.......Documedtary StatnpTax <br />- 47 ............ ................Cigarette Tax - -.. <br />45 ..........................Severance Tax- -.-....- _ _ - ,, :: - <br />71 .............Interstate bfotpr Careers Fuel Tax <br />81 x..........MotorVehicleFuelSlmportingDealer - - ~ - - - <br />85 ..........................Aircraft Fuels <br />91 ' :.......................... Spei:ial Fuels <br /> ~ --~ cra <br /> <br />- _- ~ ~ =-~ ` -1 <br /> ~- ~m <br />- ~ : -n <br />~~t~ j <br /> ~ <br />~ = +v3 <br />l <br />i 'U `h((.~~ <br />_ O ~_' <br />D <br />~ <br /> •- <br />1 <br /> <br />ti. ~,,, ~` 6 s -.1 <br />1:` ~V <br />' <br />g, - ~ G <br />; <br />4 C» ~ ~ ~ .. <br /> <br /> <br /> <br /> <br />