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Ft~ C`Cp ~ Department of the Treasury - irtternat Revenue Service <br />(Rev. SeUp4te'm9bett978~~atice Qf Federal Sax Lien Under Internal Revenue Laws <br />District Serial Number For Op(tonal f/se by RecoM/ng Office <br />OMAHA 47 ' 36580 <br />As provided by sections 6321, 8322, and 6.323 of the internal Revenue Code, ~~ <br />notice is given that taxes (including interest and penalties) have been assessed <br />against the f©Ilowing-named taxpayer. i)emand for payment of this liability fias <br />been made, but if remains unpaid. Therefcre, there is a Tien in favor of the United { <br />States on alt property and rights to property belonging to this taxpayer for the i <br />amount of these taxes, and additional penalties, interest, and costs that may <br />accrue. i <br />110 West 9th, Box 29 <br />` Wnnr9 Ri vAr_ Nc'hraalra ~ARR4 <br /> <br />Kind of Tax <br />tea <br />Tax Period Ended <br />[e~ <br />-+ <br />Date of Assessment <br />I tw` <br />- ^ unpaid Salanca <br />~ Identifying Number j o! Assessment <br />m~ 1 te1 <br />I <br />i <br />941 - Ol <br />? <br />? <br /> <br />+' <br /> <br />I <br /> <br />1 <br />i 7912 <br /> <br /> <br /> <br />~ <br /> <br /> <br />t <br /> <br />~ 1 <br />I O1-21-SO <br /> <br /> <br />j <br /> <br />I _ <br />BMF 47-0602863 ~ $2.,464.51 <br />~ <br />~ ~ <br />~ ; <br />~ <br />1 <br />j <br />mace ~r rntny Regi.star Df Deeds <br />Oounty of Ha?1 <br />4rarLd Island, Nebraska 688fl? <br />This notice was prepared and signed at _ ~~ Island, Nebraska <br />the 17th day of Mph .15 ~ <br />Total ~ S 2, 464.51 <br />on this, <br />~ryrrta.uty q\ S1 ~ j ,tiro <br />Michael\~PIVgAn-fte~ ` I Revenue Officer <br />lnv[e; V Mere o Otr;ep Uy t0 teas duanpWretlgnrenlS 15 n0l e55enflJl (O the vdntlrty OI NohCe e! <br />Fotlerai Ter 4on O.C.N. 2b4tg, tg56i, C. a. tza.7 <br />Pelt 1 - To be kept by recording ofik:e? Fwm 888 (Rev. 9-78) <br /> <br /> <br /> <br /> <br />