This government document is issued by Treasurer for use in Antelope County, NE
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https://www.google.com/url?client=internal-element-cse&cx=003873714344695240192:jm8cu3kqf-o&q=https://antelopecounty.nebraska.gov/sites/antelopecounty.nebraska.gov/files/doc/homestead%2520income%2520statement.pdf&sa=U&ved=2ahUKEwjDl5fcx8HxAhWLtYsKHWwEDP8QFjADegQIBhAB&usg=AOvVaw1W7ZV0WEE_JeaSqDOJYjER