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<br /> ti �' �'' ; INDIVIDUQL INC0Y+1E TAX " � �
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<br /> - � SQC. SEC. N0. 507131b73 �-'`.,�
<br /> �.. �� � 32325970 �_ •�.-,�-'
<br /> �- . � ' ��.f �I NEBR• IDENT� �0• . ;
<br /> • .��! SPGUSE SGC• SECo NOo 57371963i +��*.'��-
<br /> �� � YAXABI.E YEAR 1996 �}�`�`'�:
<br /> '� ' ' `� LIEN NDe 91262Q0T0 [tUSSELL C � DE80RAH LIN M HEATH !! ��'-•
<br /> 50 615 SEC�ND STREET EAS'� ��.,
<br /> �`.� BRO�KS ALBERTA YIROMB ; .
<br /> DATE �F NCTICE HAC9��� BGQKS Al6ERTA CANADA XX 69130
<br />_�_� ;� DATE OF ASSESSNENT C6/17/9T �'�"'__,
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<br /> � .�' � 7HI5 NQTICE aF 57ATE TAX LIEN IS ISSUED BV YHE NEBRASKA DEPARTP4EN� �F _
<br /> '"� ' .��.� REVEPIUE FOR INDIVIDUAI YNCC�tE 'fAX PURSUANT TC THE RFVENUE LAWS �� THg ���4��.=..
<br /> . �; STATE GF NEBRASKAa NOTICE IS NEREBY GIVEN THA7 YNDIVIDUAL INCOt�tE ' �''""�
<br /> . � 'IAXES 'I'h'CLUDItVG PENAL7IE5 AND IN?EREST9 FJ6�ICH ARE SHONN BEL�W ARE DUE �'s�"'�
<br /> ' ' FR�M THE TAXPAVER SPECIFIED ABCVE AhD l2FM�AIN UNPAID APTER DEMAND. ��� ._,.',_-
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<br /> ., � THESE TAXES �aRSHEREAFTER`ACGVIREDH� CGUNIY FOR PRQPERTY BELONGING TD . ,�
<br /> '��� 7HE TAXPAYER '
<br /> � t � j AMCUN'f QE yAll e • • o • o s • • • • • • • • • a • 3�.8�05 :'
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<br /> .� PENALTV o e . . e . o . . . . a e . . . . o e o 0 19v4t1 . .
<br /> INTEREST (tOi�PUTEU 70 09/39/97) • • • � • a a • • 24•11 , . -
<br /> ;��,� � . T�TAL AMCUNT DUE o • e • • • • o • • • • • • � a 351.56 . .
<br /> • � I NERESY CER7IFV THAT THE NEBRASKA DEPART�'1EN7 OF REYENUE HAS COMPLIED
<br /> LtiITH THE REVENUE LA�S CF 7ME SYATE �F NEBRASKA IN THE DETERf4INAYION GF ..
<br /> - THE AMC�NT SHCbN TG BE DUE• AN� ZHE TAXPAYER HAS FAILED TO PAY TNE . � .
<br /> � '� A�1dUNT DIiE A�TER DEP�lAN�o IF TI1IS NC7TCE �F STATE TAX LIEN IS AN ��� .
<br /> ' '� ExTENSICN �F AN EFFECTIVE LIE�V IT SCR11E5 TG CflNTINUE YHE PRIQRITY CF
<br /> ' � THE STATE�S INTEREST IN THE A�FECTED PRCPERTti CF YHE TAXPAYERo ,
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<br /> ' � • oe�oeY ooee�ee eeeoe oo ee�000�eeeeoo oe •so eoe���000ee�seo�e� ` . :•
<br /> � AUTH�RIZED SIGNATURE TITLE DATE .
<br /> � les TAXPAYER—Pink Copy COUNTY—Qoidenrod Copy
<br /> . � NE6RASKA OEPARTMENT OF REVENUE—Whrte end Cen3ry Cop �,�yer�g Rqr iP99 SUpOrSOd09 7•16578 ROv S91 .
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