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h <br />id~S1'i~t'i+a~ <br />.,;•: <br />pUgPOSE OF FORM. This form ~ ~ of nottfymF thehappropriate <br />Departtsrent of Revenue fos the putpo <br />county authorities that a Notice of Siate Tax Gsn is betng-filed <br />agafnstthe taxpayer indicated on this form. <br />The tax category numlierea3es and-the Nebraska tax progams they <br />zepresent are listed below. <br />SaisB Tax <br />.......~ <br />Ol ~ ~ ..Retailers Use Tax <br />C12 .. .............. _ <br />. , ... Consumers Use Tax <br />fl4 ..... ........ ~ .... Parrrnutuel <br />10 ..:..:..................... Estate Tax <br />P 46 . <br />' .. , ...income Tax Withholding <br />21 ........... <br />• ..... Individual income Tax <br />22 ............... <br />.. , , ....Fiduciax} Income Tax . <br />23 ........... <br />2~ , .... , .....Corporate Income and Franchise Tax <br />~ :. _ :..: Mechanical Amusement Device Tax <br />36 ..I~cumentary Stamp Tax <br />. • ......cigarette Tax <br />47 .......... ' ' ' ~ ~ ,Severance Tax <br />45 ....................... <br />~i , ...in*.erstate Mator Carriers Fuel Tax <br />71 ......... rtin Deaier <br />s. 81. • • • , . • • • , , .Motor Vehicle FuelSImpo g <br />. aircraft Fuels <br />,. SS ......... <br />Spe=ial Fue'ts <br />:. 91 ......._.... <br />`ts ~~~ <br />\. <br />{~yA1 <br />- S <br /> <br /> ~ ~~ m <br /> <br /> <br />r47- II 2t ..' yp ~ ~ c~ >1 <br />~ <br />~ <br />~ rv ~-~ <br />~ 3 ,~ ~ <br />Yf. m.J .N +V;-O <br />m <br /> <br />~ ; ~ <br />S's <br />}ti' _ <br />~ <br />~.- Q <br /> <br />~ .~ . O AP tJ <br /> <br />\_ ~~ ~ ~ G <br /> <br />f'G <br /> <br /> <br />