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i <br />I~~~~~~~ <br />PURPOSE OP PORM. This form is to be used by the Nebraska <br />Department of Revenue Fvr the puilsose of notifying the apprvpriate <br />county authorities that a Notice of Stare Tax [,ten is being filed <br />Against the taxpayer indicated on this form. <br />' ~ The tax category number ctx3es and-thc Nebraska tax progams they <br />represent are listed below. <br />...........Sales Tax <br />01 ................... <br />(32 ........................Retailers Use Tax <br />U4 .................. . ... Consumers Use Tax <br />IO .. . .........................Part-mutuel <br />46 ............................ Estate Tax <br />21 ................... Income Tax Withholding <br />' 22 .................... Individual Income Tax <br />23 .....................Fiduciary lncorne Tax. <br />t - 24 ...........Carpowte Income and Franchise Tax-- <br />44 ........... ;Mechanical Amusement Device Tarr <br />36 ...................Documentary Stamp Tax <br />` 47 ........... ....... . .......Cigarette Tax <br />4S ..........................Severance Tax <br />' 71 .............Interstate Motor Carriers Fuel Tax <br />81 ...........Motor Vehicle Fuels Importing Dealer <br />8S .................... . . ....Aircraft Fuels <br />` 9S ...........................Special Fuels <br /> rn <br /> <br />~ <br />es r- N <br />~ m <br />~ rT*'i z- ^^ i~ ~- <br /> tS. < ap f m <br /> .~ ~} VO <br /> <br />~ r ti.a ~ <br /> r- ~ <br />r m m <br />~ <br />~ Za ~ = r~ _.. <br />~ <br />- <br />f~ <br /> C9 ...i y ~ o <br />td <br />~. <br />11 <br /> j <br />° <br /> ..a ! # <br />~~ <br />r~-`s ~ <br />n <br />u <br /> <br />L <br />