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Form ~ ~,~ y~ IIYY ~~YYiP^~~ Cef~artmnrrn~CVOf{hn'~fpreasu(rv~-~I6nYnr~;nal Retv7lenue~+lS~rr~rvl lJcep I~~dpyY9a ~sp~~i~ <br />~'~~ (Rsv.5eptember 14T8J~ ~~ Iil~iL~°4~ ~iG~Lf1ll~~1 ~i~lA ~~~IG~ k~~d.~EiC ~1#'~~k1~IG1 ft~i~YCur11iLA~R. ~G~'YiF ra <br />~i <br />District Serial Number _ Far oPrronn- Use OY Recording O;f/ce <br />~1P.HA 4 7 35786 <br /> nr <br />~9 <br />`~ <br />As provided by sections 632>1, 6322, and 6323 of the Internal Revenue Code, ~ <br />notice is-given that taxes (including interest and penalties) have been assessed <br />against the foi{owing-named taxpayer. Demand for paymenf of this liability has <br />been made, but it remains unp"aid. Therefore; there is a lien in favor of the United <br />States on all properhj and rights to property belonging to this t;~JCpayer for the j <br />amount of these taxes, and additional penalties, interest, and costs that may ~ <br />accrue. <br />Name of Taxpayer <br />C & H Custom Hornes, Incorporate3 (A Corporation) <br />Residence <br />2212 Circle Drive <br />Grand Island, Nebraska 65801 <br /> j Undid Balance <br />Ktnd of Tax Tax Period Ended Dots of Asssssmer)t Identifying Number of Assessment <br />(a) - i (bJ rc1 <br />- t (dJ ? faT <br />941 - 01 79~ <br />i <br />i ~ 9-10-79 <br />~ ~ <br />i I <br />i ! <br />i <br />( ! <br />1~ <br />i j ~' 47--0557541 ~ $1,100.53 <br />t <br /> <br /> <br />E <br /> <br />1 <br />i'taCe Ot Filing <br />Register of Deeds <br />County Thai (~ 1.,100.83 <br />~.°rI'8x~. Islands Nebras?~s b8501 <br />This notice was prepared and signed at_.__.S~?~1 Island. Nebr~~,-,___^~_~~__ ~~__., on this, <br />the 2,5th day of S~~tember,l9'~Q <br />f He> McWilliams, Jr. ` Revenue Off~.cer <br />(P)OIR Cerflfkafe o! olfker aufhorixetl by tew fo take acknuwledpments Is not essenftal fo fhe wudiry of Nvfbs of <br />fsdarel Tax L1en Q.C.M. 26A 18, r9b4 t, Ga. 726.) <br />Part 1 -- To tw leapt by recording otfks Farm 868 (Rev, 9-78) <br /> <br />