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1 <br />Fpm ~~~ ~ ~i ~.. S.+ _. Oepartme04 Qf five Tr~aSUry -lntemal Re~+enua Service <br />'' }` _ Netice of Federal Tax lien ila~der tn4err~al Revenge. taws <br />iSi.4trtct ~ Seroei Number i For owrunar u,a ay Fccon-»v onrce <br />As prouiiled by sertions 8.321, 6322, arfd &323 of the Internal Ftstitentre Code... <br />noti+e Is;givpmtkgt;tues (iix:lutling interest and penalties) have been assessed <br />against the fotlovrireg-r4smed fiaxpap/Qr. ' f~smsJ:d for paym_nt of this liability has° <br />beeiin made, but it remains unpaid. Therefore, there is a Iien in fdvoC nf' the United <br />States an all property and ric~his ro property taefonging to this. taxpayer for the <br />amatrnt ct these taxes, and additional penalties, interest, and costs that <br />accrues. <br />Name of "axvayer Safari Bar and Lounge ~A E'~artraershzp r <br /> <br /> Varlie JehnstonT A Psartnes <br /> Wesiey Johrtstor~;,_A Partsar <br />Residentr3 l06 Easi Third Sir=,et <br /> Grand Isl.:ndy idebrssdsa 6B$Ol <br /> _ tlnpaW Beltrtea <br />Kind of Taz Tai i'eraad Ended f t)ate of Aaaeet ldentirytirt9 Numtser ~ <~ of As:asament <br />trU. ~ [al fc} (atD <br />- ~ fai <br />~~ <br />941 -- G1 - ~ - <br />{ F30I2 <br />03-ib-81 <br />Bki"r 47578184 ~~ <br />` <br />357.15 <br /> 44-13-82 °~F 47--05?8184. > .54 <br />94z -- ai ~ 81t?3 0~-a7-~B1 ~E' 47-~S781a4 97.55 <br />941 --- Ol f 81'~ 02-{?6-~E32 , NSF` t~7--057828Ti' _918.be <br />941. - of j BlC9 <br />1 <br />~ <br /> <br /> <br />~ <br /> <br />t 12.-28~I <br />t <br />. <br />` <br />i <br />I <br />i <br />3 <br />4 ~ <br /># 47~57818r; <br /> <br />f <br /> <br />t ^o4.bi <br />°leCe of Fitirq Register of 1)sads <br /> Cotusty of Ha12 Tota- j; 2t'~4.4b <br /> ^~and Island, ?Ybbraska tt~t71 , <br />f <br />Thh notice was P-epared and signcvd at -__ Viand ? s].a+"i~.s PtecrraSka , on mds, <br />ttm i{Ttli_ t3aycrf Mea~ch ,g _ 32 ^_ <br />rtls~l Pt~t:e ?Revenue Officer <br />(Ollalac Cwrttivra a> arcw r~ n,ttmvr~ as e ro sb aca>•rnr,.cgnenrr ts'-_^d. cessn,,N. ro..rnw vedra+ty nr Norbr cf <br />r=rtlrar Ire .:rn Q:wb.:6#c2, :95[x,, C.DYf 2s.) <br />Past t - To be. ke@t by +~ecosd`attg office, F-:,rm;85B d~iev. ~TBy <br />l <br />L~ <br /> <br /> <br />