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<br />
<br />Form DUD\ '..... C (J !, t,", LJ :';"~
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<br />i (Rev. FeIi;~" Notice of FederiJ Tax lien Under Internal Revenue laws
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<br />Distr!Ct '-=='_"~"m)h.;,~~\{,-:~r---------'rS'-erial:Nur:nper .----" .' 1 For OptionaJ Use by Recording Offic8
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<br />" --Ollliih-a-- --47 ,,_, (f\/;:~;d;.:<-;fM'l776 05B 523
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<br />As pr~vicfld bysee~'ons 6321,6322, and 6323 9fJhelnternal Revenue Code,
<br />notl..ii'. e.. ..(-. istt"7. I~en .that taxes ".(ine,IUd. ',i~9 i .r;td i>' penalties) have, been
<br />assessed gainst the followln"'amed ,'emand for payment of
<br />thls:lilibil Y has been made;buftt fernal .' ..' : herefore, there isa lien
<br />in favcjrof the United States on all property and',rf~hts to property belonging
<br />to thiS' taxpayer for the amouf!.l oflhes!, ta~s:;;and additIonal penalties,
<br />intereSt, and costs that may.8CCl'Ue';:,.....-".i(..":
<br />
<br />Name of t axpaye'---- -- ---to -. ----'----".,..'''...,.,.'''-,.,.,-~'-_. ." , --- -'--- ----- ,,----------i
<br />Rober s, Larry & Susan
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<br />h~_____1
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<br />Res'i(Jence
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<br />218 East 14th St.
<br />GI'\9.n~.Ls,.];and, Ne
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<br />
<br />68801
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<br />'jMI'QmAf'JTFlEL~SE INFORMA.TlON: With respect to each assessment listed betow, unless
<br />. "_.notiCEil-"_of.lien-.fs,:,refilettby,.,.the,date.-given in column (e), this notice shall. on the day.following
<br />;:_, such data.- operate.as-a certificate-of reiease as defined in IRC 63~5 (a).
<br />
<br />KTn,f61 Tax
<br />,fill
<br />1040
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<br />! TexPertOci
<br />j~nded,
<br />I' (51
<br />112-31~82
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<br />5'29 -84 -0056--
<br />
<br />Idl'nlifyingNumber
<br />(e)
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<br />Dale 01
<br />Assessment
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<br />i 04-11-83
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<br />! .,l.st Day lOr
<br />I ;Iillng
<br />(e)
<br />105-1-89
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<br />84 - 003669
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<br />UI1P!itt'!ial~;
<br />of Assessment
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<br />t$ 5,383.65
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<br />Deeds 15,383.65
<br />Grand Island, Nebraska 6880lptal 1 $
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<br />____________________.,__,,_____ _ _________________,__-,--__----------_l_
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<br />..1
<br />
<br />PIE!il6Qlf'i1il}!l
<br />Register of
<br />Ha 11 County
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<br />
<br />Omaha Ne.brask'a
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<br />This notice was prepared and signed at _____
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<br />
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<br />21st June 84
<br />Ihe ___ day of ___~,___, 19 ,,____
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<br />Signature-------;;.;,---.- ---~4 - -.- --=--- 'TTiile"--H--
<br />}4~__~~~c./-..l~h i I:!1.L_Qff i.fe Branch
<br />(N_OTE: Certificate of officer aurhorizeQ by law to taKa aCKnowledgments is nOf essential to the validity of Notice of Federal Tax Lien
<br />Rev. Ruf. 71-466, 7971.2. C.B. 409)
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<br />Part 1 " To be Kepi by Recording Office
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<br />Form 668(C) (Rev, 2-83)
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<br />-1
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