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<br />1 <br />L,~ <br />f 68 Department bf the Treasury - Inlerrtat Revenue Sarvlce <br />r=erm r^yt p ~3Ya ~y t~ rygi ®a~y~~yynnyy~~aa 'i(~+ <br />(Rev. 5oCte:nberi97B1 •~~~~~~ 0~ ~Qd~CB~ l aX ~~L~ Und@~. ~tlf~~f11~ I7GIr `a 1lY6 ~.BWS <br />DlStriCt - - t For Ophona! Use by Recordfnq dfiia <br />Sena. Number <br />~~aha 4~ ?4 <br />tt~.-pravided by ss~tions 6321, 6322, and 6323 of ,the Internal Revenue Code; <br />notice is giv=n that takes Caacfuding interest and penalties) have been assessed <br />against the fallowing-named taxpayer. Demand for payment of this! Lability has ' <br />btaen'made, but it remains uhpaid. Therefore, theca is a lien in favor of the United <br />Stati3i; on an property and :rights to -Property belonging to this taxpayer for the <br />amtxxtt of these taxes, and addtional'penaltiex, interest; and costs than may <br />aCl=rt!g. <br />Name?of Taxpayer.. <br />;David J. Dubberly <br />Restd~ence Rt. 1 Box 19A <br /> Dixtphari, Nebraska 68832 <br /> Unpaid. balance <br />Kind of Tajo ' Tai Period'Ended ~ Deie of Assessmen4 fdentifying Number of Assessment <br />(al tb7 lcl td) !eJ <br />1090 - 30- 12/31/76 07j20/81 505-72-4667 IME 2,231.51 <br />1040 - 30 12/31/77 08/03/81 505-72-4667 ~ INSF 2 , 409.12 <br />1040 - 30 12/31/78 I 07/27/81: 505-72-4667 IMF 1,614.69 <br />10x0 - 30 12/31/79 Iii 12/07/$1 505-72-4667 II'1F° 1,55499 <br />1040 - 30 12/31/80 <br /> <br />- <br />I <br />I 12/14/81" <br /> <br /> <br />{ 505-72-4667 ~' <br /> <br />I <br />L <br />- 2,139.93 <br />Place of Filing FiBgiStEL' of Deeds fI <br /> EiaY.l County <br />4arr1 Island. Nebraska fi8801 Tt~tal {'S 9;949.84 <br />This notice was prepared and signed at Qnaha A~hra-aka , on this. <br />the~dth dayof nn_~1.. ,t9..$~ <br />Signature 7 Title <br /> <br />R ~~ 1 <br />ccsald F_ E`oltz ~~ i <br />Q~ief, O£fir~ Branch <br />,_ <br />(pIQ1K CwrtilKafB of offKCr sUlborized by taw YO take acknowledgments tt not. essente8l !O f>rs Velidtty of Notf('9 OI <br />Federel.Tax t:i~n G:C.M.2W i9, 19567, C.9.723,j <br /> 'Part 1 - Ta be kerit by iecording,otfice Form 6B8 tRev. FY7ti) <br />1 <br /> L.J <br /> <br />82-~~(E~~~~~ <br />~~ <br /> <br />