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<br />, . . .:;:.'::'; I;" U L! - lJ.8 Departmental the Treeaury-Intemal Re....ueServlce.
<br />Form .(C) '-_';""~_c1M~'$';) .'. "'j"" '. '. .,... '" ' . .,;'\$1
<br />(Rev, FOb.i1983} ~~~C8l of Federa~Ja:x Uen Under' Infernall,,~).:
<br />jr~;n(;r!-'i~'!'~ .,::\: -, ?j,],-'~.- '-,-,-,-"-> :~)',::'''''-.'-;,'
<br />Dlstrl!l! . , , ,~Ial Nu""""r F/irOptlOnal,qi!ttpy
<br />~) \48417 06B 647 84
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<br />!- _: "4~ /:':,
<br />A6.'pfo~ld8dby;1tllCt!Dns~321, 63~~and6323ionhe Internal Revenue Code,
<br />notf~i' '!v.Utbi!tij~es lincl@Jn,iJntenlsf:~nd! penalties) have been,
<br />as . JJ!tlnst tnefol!owmg-nam9d laxpaym: Demand for payment of
<br />Ihls, . , lW'hasbeenl1lade, buUt..remains ,unpaid; Therefore, Ihen~ is ai
<br />lien !n:ifavor of 1~~:,Unit.~ts;tales ~h all properlly :and rights 10 property
<br />belo!'g!ng 10 ~ta}qJayer'f(j1<'Ihe"a~ount ofl~se taxes, and additional,
<br />penliltl~s, interest" }lIod "ell',ts ~lJljt may accrue~ '
<br />Name of Taxpayer
<br />
<br />Hansen, Harold
<br />
<br />Residence
<br />
<br />212 E. 12th
<br />, Wo.Q4,RicV~r" NE 68:883
<br />
<br />
<br />50'5-54-3680
<br />
<br />1,546.99
<br />
<br />;'iI
<br />
<br />iMRORTANT:REI.EAs&INFORMAT10N: ,With respect to each assessment listed beloW;.unless
<br />notl<:e:,ofllen'is"reIilect,by"the.'date given in column (e),. this nolice shail, on the day follOwing
<br />such daleroperate,as,a:certlflcate'of release as defined lIT IRC 6325 (0),
<br />
<br />Kitlit''ofTitx
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<br />10:~O
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<br />1'axP'tirlod
<br />Ended
<br />(b)
<br />,12-31,-83
<br />
<br />PIIl,C&,Qf,Flllng
<br />Regist'er of Deeds
<br />Han COunty Gr.and Island, Nebraska 6880fo181
<br />
<br />
<br />1,546~99
<br />$
<br />
<br />This notice was prepared and signed at
<br />
<br />OnahaNebraska
<br />
<br />. anthis,
<br />
<br />the 28 t h day olAugus t , 1984
<br />
<br />Signature ~.
<br />
<br />~ie~b
<br />(NOTE: Certificate of officer authorized by law to take ftcknowfedgments IS not essential to the validity of Notice of Federal Tax
<br />Lien Rev. Ru/. 71466. 1971-2, C.B. 409J
<br />
<br />
<br />Part 1 fo be Kept by Fiecordi~HJ ()fh:;;e
<br />
<br />Form 66/l(C) (Rev, 2-83)
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