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~aPSrtment Gt ilea Treasury - Miertmi Asvenue Service <br />'~ ~ '~ - loe of ~! flax Lien Under Interne! Revenue Laws <br />fRev. Saplemtre+llJTa) ~ _ . <br />? 36472 ~Q` <br />Q18t/fCt i, .5'@r~~~iJ1nb@f ~~ fw ODrwMt Uaa by HrewQU+4 (1Mke <br />C~4AHA _____ ___._ 47 .. _.~__._ ~ <br />As provi~d by aeCtiatss 8321. 8322. anti 8323 of the Internal Revenue Code. <br />notice i5 given tttat taxes (it>ciudirsg interest and pensltiSSi i,are beets armed <br />against- flee fdkwrittg-named tesct~lrer. Oemand frx payment of Phis tiahHity hss <br />been made. buf it remains unpaiQ Therefore. tts~ is a lien in favor of the United <br />States on aft property and rights to property hetor>ging to this taxpayer tw the <br />amhunt of Yhese saxes, and additional penalties, interest, and costs ttsat may <br />a6CXtte. ! <br />Name of Taxpayer j <br />Jim -ermtsrt I <br />rsidersce <br />2.!!11 East ifi.Bf't~V 30 <br />Grand Isl Nebraairs bB601 <br />lf;Ntd of Tax Tax Pwiod @tWsd Orq d Agtlpmart <br />tar rw ~ ra <br />~T"--ai^`_.~' 7g0g -- - f lz-03=79 <br />9ta1 - 0~ ~ 791.2 I d~--03-~0 <br />94Q - 14 , ?912 i 03-03-60 <br />tdtxMlryinQ NunWsr <br />BulF 47-o6ogb13 <br />Sit' 47-9513 <br />SIF 47-~So9613 <br />tat <br />E1,256.39 <br />3, 232,45 <br />13~=$7 <br />place of Pitirig <br />Asgiater c5F P?eeda Ttsf~l! ~ ~ 4,b2,k.72 <br />~tll .rattnty <br />Thb rwtkos was pt~slaared and tgprsae art _Gx'isrt~._Is3Ai1d.. ~raolsa-. _.._ _ _-.._.,_ _ ... , on this, <br />the~_. dayot .A~+T~1_ _ .ig ~?.-___ ._. __._..... <br />Titte <br />la A, 4SeLzg9t Rev~nun ~lfFirer <br />~; t: rltvh.trfr Fp <Wr+M aalfYUirlrA FW r- rII raft/ xr.-.~~W-e~IFfG>fra :f -. .-e.. ~aas~.:::.1: i.. ?aa rahday W Mvima !d <br />/rarNl ra. l wr fi C: M 2M I a r 4lIA 1 c d r as 1 <br />Dirt t -- 70 (7i ~ etr ret~rmrq WliOe Firm 66R (fiat/ 3~7H1 <br /> <br />