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__.__.__ <br />Fersn~~s Oec3rim~nt ot!he Treasury-lnfarna7 Rovenue Service <br />;Rev:ssaz.rnna:fcTat~ ~~i'~~ of Fed~~ai Tax f.ien under In$ernai Revenue ~.aWS <br />i3i,';trest _ ~ _ _ ; SBrialtNumber Foropr~nel Use or Rxurdfrrg otrse <br />Qmahi3 ~:7 - <br />__ { 4G775 _ <br />As provided bY~sections 6321, 6'322, and C~23 of the inteH~a! Reventee Code. <br />rtotireis-givanthaY`taxas tinctuding interest and penalties) have been ass~ss8d <br />against tFte foifwwng-Harried taxpayer. (?~ernand for payment cf ;his IiaCiiity iii 1 ii <<77 ?? <br />baeft matte, but'it-remains unpaid. 7hefefore, it;ere is a tiers in favor of the Uni*.ed ~ 8 `~ --~~ ~~ 1 (3 ~ c7 <br />States on ati property and rights to property belonging to this taxpayer for the i <br />attrount of these taxes, and additi~nat penalties, dnterest, and costs thaF may <br />BCCN@. ~ <br />Name of Taxpayer <br />fYand Island Iaxr: Care Inc. (a cozvorat;ion) <br />Residence ~,~ South Blaine f <br />EYand Islandr Nebraska. 683ff1 j <br />Unpaid Balao~e <br />K{n4 of Tea Ta= Porigd Ended ~ Oala of Ass3ssnarrt ~ IdertltYinq Number tN Assessment <br />r., ~ toy ~ t~) i tdJ _~ tee <br />941 - t?l ~ 3203 j o4-~2-8z I 47-05>`5a93 ~ $81,8.69 <br />a <br />s <br />s. <br />s <br />Place of fMaq 9agiater oY I}eeda <br />County oY Hell <br />Q~and Islands Haba'aaite 68801 <br />Torsi i f 8~• 69 <br />t-lwG c:~nmufe w OrlfC~l nrtnct~:ad ;rY gar rn tM• .e Mtro~f~Oprn Mfa .. rtat bSYe~iliel to the v.liditY nJ h:oti0e or <br />f~r~t T.a LfM O.GN-2t4 f9, f950. t. C.H. '7S.) <br />Part 1 - 7o b! kept by rewrding office roan 68tt ;Rea. 8-7£) <br />Thirt~atioa+wprapoedandsipnadat (Yard Ielezid. Nebraska ---------..____._ _.___.antnis. <br />tt~e_ 3rd day of ~ tg 82 <br />