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Form r~s: ' Department of the Treaswy - imr!ma5 Revetwe Service <br />igev. 2.7i7 i 0# f8f#af~ Tex t.iea Unfler )RSEfti21 Revenue laws <br />strict Sena! Na. <br />C3T5iafiha., i~ebraska 2$82$ x <br />Purwant to the Provisions of sections 6321, 5322, and 6323 of the lmerttat Revenue Code, <br />ratite is hereG; given that there have teen assessed under the 5merna5 Revenw_ laws of-the <br />United States againsT the following-Wattled taxpayer taxes (including interest and penat:ieg5 <br />which after demand-lot payment thereof remain unpaid: and tftat by virtue of tiro atwve- <br />_ ntetttiotred statutes the arrwunt of saitl !axes. together with penalties, interest. and costs <br />treat may accrue m addition thereto, is a hen in favor of the United Stales upon all property <br />atro nghis to property belonging to said taxpayer. <br />.w,.w w. ,wnw,o~ <br />Residence <br />lace of Filing Register of Deeds <br />Gaunty of Hall <br />Grand Isla. d, idabraska 6F's$J1 <br />Jerry thorns <br />For <br />Total I5 373.oJ <br />N©tice of Federal Tax Lien Refi9in J]~ <br />IRS Sariai Number 471 2a$2£R _ Recartler's ltlenhhcauon No. ___ I <br />Register of Deoas, Uou~ t,~ of limit <br />~r~Z1d TSlau":_: ~1Q „ Dave ' <br />Notice Flled With -~ ,~ ~ks`1 _ :-.~...... ---__- -- <br />,w <br />taxpayer's Ad es .l ~ ' lvan C-retie Isi~rgi_,a~p__as'a vI _ __-__- _- <br />, - __ <br />~~~~-~ (I} ddferent :hen shown aoo e! <br />signature ~ ze el_ once _ T,l,e "c.veriae ff` car ______ _ <br />15`J$ sylvan <br />Grsnd Island, I>Yebraska 6$$Ol <br />$~ ~0~~~~ <br /> <br />Kind of Tax <br />(a) <br />Mr 5 <br />{b) <br />Tax Period Ended <br />(c) <br />Date of Assessment <br />{d) <br />~ Identifying Number <br />~ {e) Unpaid Batance <br />! of Assessment <br />~ {f) <br />1J40 3D 12-31-74 05-26-75 SG7-32-~3E5 ( 373.0© <br /> <br />a <br />~ <br /> <br />~-c i <br /> <br />_.------ <br />wf-neas my nand at Grand Island, ;+ebraska <br />-___-__...__.. _...______ _.._. ____..-_. _.____ ._ __._.-_ .on this. <br />the 1b dayot_ June 19 75 <br />Signature ~s/ Lyle D. :ietz~~er-_---Title __rieveaue officer-_------_-- <br />{NqM: Certificate of officer authorized by law to take acknowledgments is not essential to the validity of Notice of <br />Federal Tax Lie» G.C.M. 26419, C.B. 1950.1, 125.) <br />Part 1 - To be -eetefnsd by recording office <br /> <br />