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Form I~1W _ Depanment of the Treasury - m(arnal Revenue Service <br />,qv. DecamGer,9fl2, ` ~~` `~J6tlca~raf~Federal Tax Lien Under Intemai Revenue Laws <br />Dfstriet Serial Number For Optional Use by Re <br />oidmg O//fce <br />c <br />. ,. _ 42580 rr <br />tt <br />~~~. i~VO~~~,:~„ <br /> <br />As provided by seetiolis 6321, 6322, and 6323 of the Internal Revenue Gode, notice is given <br />that taxas`fincluding Interest and penaltieslhave been assessed against the following-named <br />taxpayer: ~Demandf for payment of-obis Jiabfiity has been made, but it remains unpaid. <br />Therefore,-there is a lien in favor of the United States on ail property and rights to property <br />befonging to this taxpayer for the amount of these taxes, and additional penalties, interest, <br />ahd costs that may accrue. <br />Name of taxpayer <br />Raui A. Hernandez, Sr. <br />Residence 410E 11th St. <br />Grand Island, Nebraska 68801 <br />IMpt)ttTANTAELEASEINFO1MtATtON -With respect to each assessment list below, unless notice <br />of lien is reNledby the date-given in column (e), this notice shall, on the day following such date. <br />operate as a certifidate of release as defined In IRC 6325 (a). <br /> Tax Period- Date of Last Day for Unpaid Balance <br />Kind of Tax Ended Identifying Number Assessment Rattling of Assessment <br />(a) (b) (c) (d) (e) {f) <br />1040-30 7812 508-30-3574 07-06-81 08-OS-87 $1,550,69 <br />1040-30 7612 508-30-3574 09-03-79 10-03-85 $ 266.50 <br />1040-30 7912 508-30-3574 05-26-80 06-25-86 $ 479.96 <br />rtaceornxng Register of Deeds <br />Hall County Tout ; 2,297,15 <br />Grand Island, Nebraska 68801 <br />This notice was prepared and signed ai <br />the.28th day of .Ianuar~, 19~_ <br />on this, <br />D.D. <br />(NoM: Cersrficwe of officer ¢ut?rorized by law ro coke ¢cknowledgemenrs is nor euennol ro the .¢tid~ry of Nonce of Federo, T¢x Lien <br />G.C.M. 26414, 1950-i, C8. ]25-) <br />Part t - To be kept by recwdhg olfica F.,r~, see rAe. iza2+ <br /> <br /> <br />