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<br />~ D©partment ofttie Treasury-InternelRavenue9arvdce <br />Farm ~, <br />~Jotice of Federal Yax tier Under lnterna! Revenue Laws <br />i <br />~, <br />R <br />a., ~epln~~r, <br />3T <br />~ <br />~ <br />District T-~Sprial Number For oPnonpr uae py aecoa~ng omce <br />OMAFIk !¢7 If 41270 rd5 ~ '°' ~ } ~i e~ ~' <br />As provided by sections 6327,` 6322,_ and 6323 of the Jntemal- Revenue Code, <br />notice is given that taxes (incltading interest and penalties)' have been assessed <br />against tfia following-named taxpayer. Demand fort paymegt of this liability has' 'I <br />been made, but i? remains unpaid. ?herefore, there is a lien in favor of the United- ~ <br />States nn aii property and rights to properfj belahging to Shis taxpayer for the <br />amount of these :axes,:and"additional peraities. interest, and 'casts that may- <br />' accrue. <br />Name of Taxpayer - - <br />Cliifuxt C. & ~Je.ra M. Petrberton <br />------ ~( <br />Residence j <br />513 E. 15th ~ <br />Grand Islands Nebraska b880? <br />-! T- <br />i Unpaid Balance <br />Kind of Tax ! Tax Poriad Eftded Date:: of Assessment <br />Identifying Number ~ of Assessment <br />rei i rn; t tcf «r i <br />- r~; <br />- <br />1040~30 $012 i Ob-22-$i 377-3b-33ry0 IMF' ,~9.oi <br />104030 x112 ~ OS 21c-Fs'2 i :77-3b-33'70 IMF ~ <br />j <br />', , y <br />~ } <br />f <br />{ ~ f,~091.08 <br />Place of Filing ~ <br />Register of Deeds <br />Co,:nty of Mall Totaf ~ S asa'J.75 <br />Grand Islands Nebraska 58301 <br />Grand Islrsids N _braska <br />This notice was prepared a~~d sgred at _____ ____.___.-_.__.__ ___._ ___. _.__. -. _... ___ _.__.. ~ cn thi,. <br />1^th T~ i ~ <br />the J---- day of ~ a..y----- 7 g ~` ---- <br />Signature _ Tiri~ <br />~[n~ <br />Lyie D. Metzler ~ ~' ,`P --~ Revernze Offerer _ <br />jNob; ~e .rf race c~rr,cQr aut~c~rce~ cy- 'Ed'e .,~ aeJr:e rtts ; nM clean ~~ ,ne atlwty rra,;ea o <br />Fer.~ra' Ta. Far G,_'_AI. ?6A~9, .Y '3-;. ';:. 8. '.:~) - <br />Part 1 -- To be kept 6y recording office Farm 66d (Rev, s-~ 8) , <br />t_~ <br />