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Form ~ Department of the Treasury-Internal Revenue Service <br />tRev, Saptamher1478)f No#ice af~ Fetleal~Tax Lien Under Internal ReYenue Laws <br />I~PStrICi $etfaf Number Far ORFOnet Use by Recarding Otrica <br />OMAHA l+7 36503 <br /> r <br /> <br />p ~ <br />~®~ ~~` <br />~ provitted by sections 6321, 5322, and 6323 of the internal Revenue Gode. <br />~ <br />notice is given chat taxes (including interest and penatties? have been assessed <br />against 1ha following-named taxpayer, Demand for payment of this liability has I <br />bean made, but it remains unpaid. Theref~, there is a lien in favor of the United f <br />:Stales on ail property and rigfits fo property belonging to this Taxpayer for tfie ~ <br />amount of these faces, and additional penalties, interest, and costs that may <br />8Cl:ille_ <br />Name of Taxpayer <br />lack Franssen <br />Flaasset: AfasDnry <br />ffi~derece <br />?~r7 Norttt iiebb RoaQ <br />Brand Islatxi, Piebraska ~SOI <br /> Unpekl Balance <br />KMrd of Ta: Ts: Period Ended Gets d As~mettt t <br />detttifying Number of art <br />raj tD1 .a7 .d/ IN <br />- <br />j '7903 <br />~ ,20-79 <br /> <br /> <br />11 ~ ~#F 47-05973 <br /> <br />I <br />j~ 355. <br />~ <br />~ i <br />R+e~~.ster ai Aeeds <br />I~a31 0oamty 3ota1 ~ S 355.33 <br />( Is2tsad, ATebraska 58601 <br />Tltier>t~inerr~sprepatadandsignedaf Grs~id IBland~ Nebraska --_,anthis- <br />tfie~. dayaf ~~ ~19 ~ <br />&avenue flf.'f~cer <br />nraFk Cartq~luuls rA aa+pr a+M+onsW or taw to tsaa ar.Ano«hdyaasnts ,: nu assearr/ to tM rNMitY of Nptce of <br />fwoMal Tea t.imt 6.G.Y. ?8178 t%Ft, C. B. 7Y3.) <br />PaN 1 - To fie iospr fig' reoor~ ofFiCe-' Fmm 6t3ti tRev- 9-Te l <br /> <br /> <br />,J <br />