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<br />_ Form 6S8 i „__. ~ D.anarlmen! v1 the Troxaury - 7n!emaP Revenue Service: - <br />iAev 5epinmber,g7P; Notice- of Federal Tax Lien Under Internal Revenue Lanus ~ <br />District Serial Number ~-FOB ou:~onar u,o o>, ad~urd~~9 oin~a <br /> <br />As provided by sections E321, E322, and 5323 of the Intemzl Revenue Code. <br />notice is given that taxes ;including interest and penalties; have been assessed <br />against the following-named taxpayer. Demand for payment of this liability h~ C <br />been made, but it remains unpaid. Therefore, there is a lien in tenor of the United ~ <br />States on al! property and rights to property belonging to this taxpayer for the ~: Q ~ ,,,~ ~ 3 ~ 9 <br />amount of these taxes, and ~dditieaai penalties, interest, ahd costs tttat may. C~ <br />accrue- <br />Name of Taxpayer <br />'offi^sy° T. Bourke <br />I <br />Residence _ <br />Route'1, Box 1$G I!, <br />elm Creek, "rIebraaka bs383b <br />~ Unpaid 8alanCe <br />Kind of Tau j Tax Period Endue I Date of Assessmsr~t Identityf~ Mumber ~ rat AssessrnMt <br />f~) ~ !bl 'cl 1 lo).. <br />- I <br />1040-30 ~ 7912 ~ OE-lti-$2 ! Ii='1F' 505-$6-5$45 2,0$b.60 <br />101a0-30 ~ $C12 t7~-16-b2 j Ib~ 505-$$-5$45 <br />j ~ 3,$00.$5 <br />I <br />Place of Fitirtp Register of Deeds <br />Count of Ha'.i ~ 5, 5.~5 <br />u"Yandylsland, hebraEka bg$ol TooliS $g ~ <br />This notice was prepared and signed a+, -Grand ZSland~.+lebraska -- --, ------- -----_---__-• on this, <br />tre 26th day of August ,tq _ $2 _ - <br />Signatur {>, , itle <br />A~.i.hael Ponte Yevenue Gfficar <br />__ <br /> <br />(tia1.: Certth«!a ur ottrc a' •~fr;o.. b n. <br />~ I <br />r, tore ac~rou~tytlpa-ion's ,- no. e.,..on~.or .~ tM1e +al:Qily 71 Mu:lce of <br />Fa1Ve: Ta. Lre~ G.C. 4. 261x5, i9~~' '=H, i'i.i <br /> Part 1 - To be kaPt by recording office Fvm, k36a iiiev ~78J <br /> 4.~ <br />