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_,, .. <br />~_ <br />9~~t~~ce~ ®f St~-~'~ Tex Li~rr <br />..,>eormftta <br />t <br />tifrwanere ''. eAeal~ irtsYruDYroera ori~ raeerm ~~' <br />~$~r(af NpmWr Litln 7vpe ~:: Dftd^'.' Sa9t [Security Number <br /> <br />2 ~r191naP <br />^ R.hawa, <br />12-1-$1 <br />505 34 8268 <br />~ ~ .~ ~ ~ S 9 ~ ED <br />_ <br />Nebraft<a I.D. No. County LIM Filed wttn SpoufeY Soclai Security <br /> Regttter oT Dead Numeer <br />79100b Nall [~ cpRnty a.rk <br />- Bt1StNESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />eueinfr% Name Name <br />Gerald Rock Grand Island Copy Company Gerald E. Rock <br />Straei Atldfa# Street or Other Maiirn9 AOtlretf ___ <br />t 404 West 4th Rural Route 3, Box 15A <br />City Steta rID Cotls City Sete <br />Grand Island, NE 68801_ Grand Island, NE <br />zap code <br />68801 <br />That Notice of State Tax Lien is issued by the Nebraska [kpartmeat of Revenue for unpaid taxes pursuant to the <br />revenue laws pf the state of Nebraska. Notice is hereby given that taxes including penalties and interest, which are <br />shown below, arc due Gem the taxpayer specified above apd remain unpaid after demand. These taxes constitul~ <br />a lien in the county far r~l and personal property belonging to the taxpayer tx hereafter acquired. <br />Tax <br />( <br />Tarr Period tAra of <br />Axfemnem <br />Amount of Tax <br />~ Penalty <br />Inargt <br />Additiorra <br />A Bapamerrt Du. <br /> <br />O1 -1-81 thru <br />-31-81 <br />8-31-81 <br />258.42 <br />j 7.95 <br />9,12 <br />275.49 <br /> <br />1 7-1-81 thru <br />-30-81 <br />10-30-8 <br />862.73 <br />43.14 <br />10.26 <br />916.13 <br /> <br /> ' - ~ <br />~ <br />`-- <br /> <br /> <br />TOTAL ( $ 1141 fit <br />I hHeDy Certify that the fWbrafka Department Of Revenue has t:Onlplietl wltn the revenue laws Of the State of Nebraska In the deter <br />minatiOn oT the amount shown l0 De due. and the taxpayer hat }dlletl Io DaY the amount due after tlemintl. IT Ihit Notice Of State Tax <br />Lien If an exbnilon of an effet(IVe Ilan it Servos to Continue the PrlOtitY of the State's Interest In the of feCtetl property Of the laxpayef. <br />_ Revenue Agent ~l-~ - s-/ <br />i!~!! ~eP~`y afore Tltte Dats <br />- - Special Agent i.^ •,? -F~j! <br />AutnwtLd fora Title Date <br />NEBgASKA DEPARTMENT OP REVENUE - WAiq and Goldenrod Copiu TAXPAYER - Pmk Copy <br /> <br />COUNTY OFFICE -~ Canary Copy <br />a.avs-><a Rey, r.at <br />SuReraedaa 4-eBd•'td Rav. ti-90 <br /> <br /> <br />