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Notice of State Tax Lien <br />NOTICE OF STATE TAX LIEN <br />INDIVIDUAL INCOME TAX <br />IF YOU INQUIRE ABOUT <br />YOUR <br />ACCOUNT: REFER TC THESE NUMBERS <br />SOD. SEC. N0. <br />506543976 <br />NEBR IDENT. NO. <br />30393264 <br />SPOUSE SOC. SEC. NO* <br />505640673 <br />TAXABLE YEAR <br />1979 <br />LIEN NO. <br />86145076 <br />COUNTY <br />MERRICK <br />DATE OF NOTICE <br />U5/25/E6 <br />86— .103762 <br />DOUGLAS A P MARY I COTANT <br />BOX 1473 <br />GRANT ISLAND <br />;t <br />NE 68802 <br />THIS NOTICE OF STATE TAX LIEN IS ISSUED BY THE NEBRASKA DEPARTMENT OF <br />REVENUE FOR INDIVIDUAL INCOME TAX PUkSUANi TO THE REVENUE LAMS OF THE <br />STATE OF NEBRASKA. NOTICE IS HEREBY GIVEN THAT INDIVIDUAL INCOME <br />TAXES INCLUDING PENALTIES AND INTEREST* WHICH ARE SHOWN BELOW ARE DUE <br />FROM THE TAXPAYER SPECIFIED ABOVE AND RE14AIk UNPAID AFTER DEMAND. <br />THESE TAXES CONSTITUTE A LIEN IN THE LOUNFY FOR PROPERTY BELONGING TU <br />THE TAXPAYER OR HEREAFTER ACQUIRED. <br />AMOUNT OF TAX . . . . . . . . . . . . . . . . . . . . . . . 974.26 <br />PENALTY . . . . . . . . . . e . . . . . . . . . . . . . 243.57 <br />INTEREST (COMPUTED TO 05/25/86) . . . . . . . . . . . . . . 833.70 <br />TOTAL AMOUNT DUE . . . . . . . . . . . . . . . . . . . . . 2,051.53 <br />I HEREBY CERTIFY THAT THE NEBRASKA DEPARTMENT OF REVENUE HAS COMPLIED <br />WITH THE REVENUE LAWS OF THE STATE OF NEBRASKA IN THE DETERMINATION OF <br />THE AMOUNT SHOWN TO BE DUE, AND THE TAXPAYER HAS FAILED TO PAY THE <br />AMOUNT DUE AFTER DEMAND. IF THIS NOTICE OF STATE TAX LIEN IS AN <br />EXTENSION OF AN EFFECTIVE LIEN IT SERVES TO CONTINUE THE PRIORITY OF <br />THE STATE'S INTEREST IN THE- AFr CTEU PROPERTY OF THE TAXPAYER. <br />• •••. •.•... .Y. rr •. .•. •...•....... <br />PREPARER'S SIG ATURE TITf -E DATE <br />AU • ZED STGNAT RE TI E •DATE <br />FOR COUNr'Y `iFFICIALSS USE <br />L --_— <br />NEBRASKA DEPARTMENT OF REVENUE OFFICES <br />,r you rave am +1ue;Lo�s •m;a rd s ease ��.tau rras..a G . - - -• Lc. 918:8, C9, 01 any nr <br />t!,e re4ia na, 'v 11!Cei 110W Je:ow e_,as. .+ .. " °ar a:w 7,e' :' ee, ru, a .a. c < -2 s ,,nuer er o 070 112 7474 1- aSV S:a n:e <br />LINCOLN - i402I 471 -2971 GRAND ISLAND - (3081 3848829 NORTH PLATTE - 13081 5328250 <br />OMAHA - !4021 5544065 NORFOLK - 14021371 1620 SCOTTS BLUFF - (3081632-3637 <br />NEBRASKA OEPAR7MENT OF VYn ., ar,.,; ca,—, C •c s ?AXPAY ER P— Coo, CUUNTY Ga!der,r �<1 Cepr <br />I <br />I <br />tom+ <br />101 <br />ic`= <br />