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8i 104419 <br />Feaa illwr) 150 <br />,.�....�..,.. �, ..........,, - ..................- - .... -- <br />(Rev.Deumber1065) - - Notloe.,of Federal Tax Lien Under Internal Revenue Laws <br />District <br />Serial Nurnber <br />ferOptlan/ &W Otrla <br />Omaha, NS <br />478726769 <br />b Id6d by sections 6321, 6322, and 6323 of Via Internal Revenue Code, <br />noflae Is yhren that tuces (including Interest and penNNes) have been <br />assessed against the following -named taxppyer. Demand for payment of <br />MN 6abi1 hu been made, but R remains unpaid. Therefore, isaat�lion <br />pethen <br />Nt favor o United States on all pro rt anti tight* t a r fio al belonging <br />to this taxpayer for the amount of tthh�e <br />btterest, and costs that may accrue. <br />Name of Taxpayer <br />Kosmicki, Alfred J. & Judy <br />Residence <br />217 West 11th Street <br />Grand Island N8 68801 <br />IMPORTANT RELEASE INFORMATION: With respect to each assessment listed below, unless <br />notice of lion Is refilled by the date given In column (e), this notice shall, on the day following <br />such date, operate as a certificate of release as defined in IRC 6325(x). <br />Tax Period <br />Data of <br />Last Day for <br />Unpaid >salanos <br />Kind of Tax <br />Ended <br />Identifying Number <br />Assessment <br />Rattling <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(r) <br />1040 <br />12 -31 -84 <br />508 -54 -4750 <br />9 -29 -86 <br />10 -29 -92 <br />3255.67 <br />Place of Filing <br />Register of Deeds Total <br />$ <br />Sall county <br />3255.67 <br />Grand Island, NS 68801 <br />This notice was prepared and signed at Omaha, Ns on this, <br />the -day of July 19 87 <br />Y <br />Signature Title <br />o 17110-221-5 38 Revenue Officer <br />(t10TE: t7te Of D1fICer aulhorizetl y w wledgments Is not essential to the validity of Notice of Federal Tax Ilan <br />Rev. Rul. 71 -4ee, 1971 - 2 C.S. 409) Form 668(Y) (Rev. 12.95) <br />Part 1 - Kept By Recording Office <br />n <br />r' <br />f <br />