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<br />Form 6111 Fk'poRment G! tho Tre9eUry - tnFBmal RerOnua 3erviGU <br />{~e,, sePte,.~.;fl-8,i Notice of Federal Tax Lien Under Internal Revenue Laws -~ <br />17istric2 TSerial Number ~_ vo. oPrwrer u=e br axo-mnv once <br />Omaha ,7 ~ 41649 ~ <br />qs grovtdetl by sections 8327, 8322, and 8323 of the Internal Revenue Code, i <br />notice is given that taxes (ine!uding interest and penalties) have been assessed <br />against the following-Warned taxpayer- remand for payment of this liability has <br />been made: but it remains unpaid. ?hereferF~, there is a lien in favor of the United <br />States on atlproperty and rigMS to prepe,ty beicnging tc this taxpayer for the ~ <br />amount of these. taxes, and additional penalties, interest, and costs that may ~ <br />accrue. ~ <br />I <br />Name of Taxpayer - - ---- -- -i <br />I <br />Dallas A. Friesen <br />82-()~~?8R8 <br />Residence L44 Beck Road ~ <br /> Grand islands Ne^raska 68801 <br /> <br />Kind of Tai <br />I Tax Period Ended ; Date of Assessment <br />i Identifying Number Unpaid Balance <br />~ of Assessment <br />r~r <br /> <br />T ~ roe i ;w <br /> <br />- t te1 <br />_~ ~ ..) <br /> <br />- <br />1040 .~. 30 I j <br />7812 f 08~25~82 i Ii`+~' 503~72~!a069 8213.73 <br />1040 30 7912 ~ 08.25-82 i IhIF SOS-724069 8389.11 <br />1040 .. 30 I 8012 { 08-25.82 ~ ZMF 505~72~=069 7720.13 <br />Place of Fltinq ~ <br />Register of Uaeds <br />County of Ha11 Total ; = 24322.97 <br />Grand 1sLand~ Nebraska 6880? <br />i <br />This notice was prepared and signed a! Grand Ialand~ Nebraska__-___________ __ , on this. <br />fhe 30th dayot?~guat ,t9 82_ <br />Ssgnature ,^--fir ~ /-~--- ~ Titie --- ---~--- <br />L le D. Metager 11 I ~`'"''~f~~~ 'Revenue Officer <br />iMW~r CertiY~l~ or OflAI, ~~UlltarR Bd vY l6 [O -Sw~ ff Rn pwr~Oyms.'rs ;S na[ •SSBnbd/ f0 fns vL}nJiry Ol NOrke b) <br />F~,i/ Tu lNn O.C.AI_ iNt?, 19yP!, C.B. 125.) <br />Part 1 - To be kept by recording office Form ~ ,Rev. a78) <br />