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020110 Dspartmant of the Traaaury - Intamat Revenue Service <br />- - <br />Form <br />(Rey. Feb. i9a3) _ Notice of Federal Tax Lien Under Internal Revenue Laws <br />_- -_._ --- ---- --- - - -- -, Serial Number PoroprronaruseM�Recoran9IXrce <br />District <br />Omaha 47 53685 12C 161 96— " 100572 <br />As provided by sections 6321, 6322, and4323 of the Internal Revenue Code, <br />notice is given that taxes (including interest and penalties) have been <br />assessed against the following -named taxpayer. Demand for payment of <br />this f tteopi unpaid. s t there <br />In <br />favor o he United States on all property an h o property belonging <br />to this taxpayer for the amount of these taxes, and additional penalties, <br />Interest, and costs that may accrue. <br />Name of Taxpayer Nielsen, Dennis F. <br />Residence 2202 Riverview Drive <br />Grand Island, NE 68801 <br />IMPORTANT RELEASE INFORMATION: with respect to each assessment listed below, unless <br />notice of lien is refiled 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 (a). <br />Tax Period Date of Last Day for i Unpaid Balance <br />Kind of Tax Ended Identifying Number I Assessment Refilling of Assessment <br />/a) (b) I - )C) -� . r 17 -6 7_ -- <br />I � <br />i <br />j <br />I <br />I <br />I <br />i <br />Place of Filing Register of Deeds 34,176.27 <br />Hall County Grand Island, Nebraska 68Mial $ <br />Omaha Nebraska <br />on this. <br />This notice was prepared and signed at <br />6th January 86 <br />the -- - -- day of --. 19 - <br />Signature 4,--t ,. 4 <br />1133 Lyle D. 6tz g er Revenue Officer <br />_ <br />(NOTE: cerldicare of officer authorized by law to rake acknowiedgmenis is not essCnnal 10 the validity of Nonce of Federa% Tae Lien <br />Rev. Rul. 71 -466. 1971.2, GB. 409) <br />Form 668(C)(Rev.2.83) <br />i� <br />i I <br />