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<br />Forth CCO Department of fhe Treasury ~ Inlemal Revenue Service <br />~~,,, seplembe.,~ai Notice of Federal Tax Lien Under internal Revenue Laws <br />District Serial Number For Opfionet Use by Record/ng Office <br />Omaha 41994 <br />As pprovided by sections 6329, 8322, and 6323 of the Internal Revenue Code, <br />rtotice is given that taxes {including interest and penalties) have been <br />~' <br />` <br />7B3 <br />assessed against the following-named taxpayer. Demand for payment of ~~ <br />,~ <br />82 ^ <br />this liability has been made, but it remains unpaid. Therefore, there is a lien <br />in favor of the United States on all property and rights to property belonging <br />to-this taxpayer for the amount of these taxes, and additional penalties, <br />interest, and costs that may accrue. <br />Name of Taxpayer <br />Rncloaey L. Muir <br />Residence <br />312 Comanche Ave. <br />Grand Island, NE 68801 <br /> Unpaid Balance <br />Kind of Tax Taz Period Ended Date of Assessment Identifying Number of Assessment <br />(a) ISl (~) (dl !el <br />1040 12-31-a1 o5-z4 82 Soy-8o-121b $1r774.21 <br />wace of rnmg <br />Register of Deeds <br />Hall-County Total $ 1,774.21 <br />Grand Islandr NE 68801 <br />This notice was prepared and signed at Omaha, Nebraska ,on this, <br />tha2$#rh_._dayof October ,19 ~ <br />~~~ <br />held F. Fi <br />(Holt. Cen!licate or olticer autnorized~ <br />ederat raz lien G.C.M. 264t9, 1950.1, C.B. <br />~ ~ Chiefr Office Branch. (Acting) <br />law to take acknowledgments is not essential ro the vafidify c! Notice of <br />Part t - To be kept by recording office <br />Form 868 {Rev. 9.78) <br /> <br />1 <br /> <br /> <br />