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~ .~_e_ ~-..._ <br />3 Form ~~~ Qepartment c: the Tre.,^ury -lnternx! Re'+enuP S¢rvice <br />Notice of Federal Tax l.ier€ Jnder lnte~na3 Reve~iue Laws <br />(Rev. September 7978) ___ _--'-- '-_~ <br />DiStfIC2 -~_ - I $BrFat-NUmber Far Ogtionn! U~r by ftcLPtCin9 Of1iG3 <br />e QltAhtA ~~ ~ 3r;5~5 ~~~ ~F.!°~.~a~. <br />f As provided by sections 6321, 6322, and X323 of the Internal Revenue Cade, <br />notice is given that taxes (including interest and pena)hes} have been assessed <br />against the foilowing-named taxpayer. Demand for payment of h s (lability has <br />been made, but it remains unpaid. Therefore, there is a lien in favor of the United <br />States on ail property and rights to property belonging fo this Taxpayer for the <br />amount of these taxes, and additional penalties, interest, and costs that may <br />accrue. <br />et <br />Name of Taxpayer <br />i. Larry E. and Karen Carlson <br />2836 Goldenrod Drive <br />GrFUid Islandr Nebraska 68801 <br />.... <br />j Unpakl t3alance <br />Kind of lax Tax Period Ended j Data of Assessment ! tdentitying Number of Assessment <br />(a1 (D) (W ftl) (e) <br />- l~T+~ - 3 ~ 712 05- -79 ~_ IN:F 50~ 313 ~i r 10'7.95 <br />03-200 ! 37.92 <br />r ~ . i <br />i i <br />Place of Filing ~ ~ ~ <br />Register of Deeds i <br />fial.l County TO~I iS b,3.tr5,6i <br />Grand Islandr Nebraska 68802 <br />-This notice was prepared and signed at- Grand Island: Nebraska `____,-________ , on this, <br />the 10th day of March __ ,ts 80 <br />Signature ~~-N~~~~~ Title <br />Ze D, etzg r ~ Revenue Officer <br />(NCtu: Cortiticeto o/ otf~POr outhorized by law to take acknew(ed9manti L5 nPt 839e.'•tial 7P tho validity of NPhcP Pt <br />Fadent tax Uen G.C. M. 2$479, 195n-1. C.a. 725) <br />Part t - 7o be kepf by recording office'' Form 888 (Rev. t)-7s) <br /> <br /> <br /> <br />