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Form 6CV Department of the Treasury ~ Internal Revenue Service <br />(Rav. septamber is78) Notice of Federal Tax Lien Under Internal Revenue Laws <br />District Serisi Number For Optional Use by Record/ng Ol/lca <br />OMAHA 47 <br />As provided by sections 8321, 6322, and &323 of the Internal Revenue Code, <br />iven that taxes (including interest and penalties) have been <br />notice is <br />w *~i <br />~ <br />g <br />assessed against the foltowing-named taxpayer. Demand for payment of 1 <br />82 ""~ V 4 16~ <br />this liabittty has been made, but it remains unpaid. Therefore, there Is a lien <br />in favor of the United States on ail 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 Wiley 0. Sandi in <br />d/b/a Grand Island Welding <br />Residence 3244 8actunan Road <br />Grand Island, Nebraska 68801 <br /> Unpaid Balance <br />Kind of Tax Tax Period Ended Date of Assessment Identifying Number of Assessment <br />(a) !bl (c) ld) (e) <br />941 - Ol 8109 0607-82 BMF 47-0573177 2,705.23 <br />941 - 01 8112 06-i4-82 BMF 47-0573177 1,369.81 <br />940 - 10 8112 07-05-82 BMF 47-0573177 294 J9- <br />941 - O1 8203 0816-82 BMF 47-0573177 1,221.73 <br />941 - 01 8206 10-25-82 BMF 47-0573177 1,320.06 <br />Place of Filing <br />Register of Deeds <br />Hall County Total S 6,911.62 <br />Grand Island, Nebraska 68801 <br />This notice was prepared and signed at Omdhd , Nebraska <br />the 29th day of October ,tg 82 <br />,on this, <br />I Itie <br />avid B, Adams 1211) Group II Manager (Acting} <br />ltNf~tWa• Certificate of officer authulzed Dy law to take acknowledgments s not essential to the vahdrfy of Notice of <br />Federaf Tax Lien O.C.M. 26479, 1950-Y, C,a. 125.J <br />Parr 1 - To tl'a kept by rsc,^,ra;.'i a office Form fi6a (Rev. 9-78) <br /> <br />1~ <br /> <br />___.3 <br /> <br />