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<br /> Notice of State Tax Lien � � �����=Nr
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<br /> j PLEASE QO NOT WRRE IN THI6 SPACE ,
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<br /> Thts Notkc of State Tax Ueo is l.gsued by tde Nebtaslw Departmeat aP �_•�=°--�-
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<br /> Revenne for unpald taxes pucsuent to the revenne I�ws o[the sGtte oi
<br /> Nebraska. Notice is 6ereby glven t6at taxes iacluding penaltks and ��'
<br /> • � inte�+est,whkh �re shown bebw,rre due trum We G�xpRyer speciNed �"'�"'�"—
<br /> i �-`Y
<br /> bebw and remnin unpatd pRer demaad. Thesc taxes constitutc a lien in ��y „
<br /> - } t6e rnunty tor rwl and personal property bc�onging W the taxpayer or �•:"��-
<br /> 3 6ee+eattcr ac uired.
<br /> � }.•� Nebr��lu Id�rMMcabo�Number Uen Flled Nfith SoGal Securfry a Federal I.O.Number Spou�e's 3oclai Securlry Number �4��;� ,
<br /> � 40233510 �R�s��rotoeed. ❑ca�myc�er� 505-72-1380 ��_
<br /> nac�a uen �r ;;,•,--
<br /> �' ue�s 8/02/310 ���+� Qc«nx�wuu«� Q c«reaea 1-28-9 8 HAI�L t:
<br /> TAXPAYER NAIAE AND MAIUNQ ADDRESS � :�`
<br /> ' BUSINH83 NAII�E AND LOCA110N ADDRES9 Name , '�'-
<br /> � ' ���� LI�3DELL M HP.GWOQD I I -
<br /> soreee�ad�ess svee►«on�er M.wo9�aarea `,t
<br /> 901 WEST 7TH �: -
<br /> � ry�e ZipCode Gry Stab 7jP�� ��
<br /> GRAND ISLAND NE 68801 ��
<br /> D�t�of p�unt of Troc P�nNty IM�n�t AddRIoM ��t� �•
<br /> �� T�x PKlod ��g _ _
<br /> f' ,,�
<br /> �' 2Z 1991 8-6-97 359 .00 89.75 185.56 634.31
<br /> L•' �
<br /> �� ZZ lgg2 8-12-97 632.00 158.00 250.91 1040.91 — _
<br /> j" 22 1993 9-26-97 721.00 180.25 235.78 1137.03 °
<br /> , 22 1995 9-10-97 322.00 80.50 51.85 454.35
<br /> � 22 1996 6-18-97 478.00 23.90 33.94 535.84 _
<br /> �, —�,-
<br /> � ' TOTAL $3 8 0 2.4 4 �,,
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<br /> I hereby certily tliat the Nebraske Deparlment ol Re'„e�ue has comWled with the revenue Iaws of the State of Nobraekn In the detxminatlon
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<br /> ot Uie ertaurrt ehown to be due.and the taxAaYer has f�letlro pay the amourK due elter demarW.Ii thle Notke of SO�te Ta�c Uen Ison mRennlon ot �:`t. � �
<br /> an eNective Ilen,It serves to ooMhwe the prbrity of the etate'e I�erest In the aflected prope�ty of Ne tnxpayer. :�:��i°.��:�--�•
<br /> `i Si9n ����r�l.��� � � 2-� ��} ����,�s$ ��,� - .�,�.�,. . +.-
<br /> g Tele�hw�e No.
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<br /> NEBRASKA UEPARTMENT OF REVENUE•WhRe and(ioldanrod Coples TAXPAYER•Pink Copy COUNIY OFFICE•Ccitlary Copy
<br /> I ������� 4-59�1-7�Nw.1Pfl6 S�pws�dM 1-49474 Rw.6.96 ..
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