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r <br />1 <br /> <br />Porm ~V department of the Treasury - Uternal Revenue Service <br />(Rev. September187ai Netice of Federal Tax Lien Under internal RevBnue Laws <br />Usstrict ~ Serial Number For oAtlene/ Use by Necord/nq OMece <br />Omaha 47 38221 ~ 1 _(~ (- L 3 3 <br />r5s prevx.+ed by sections &S2t, 8322, and ~s323 of the Internal Revenue Code, <br />notice is given that taxes (including int6 ~est and penalties) have been assessed <br />against the following-named taxpayer. Demand fot payment of this liability has <br />been made, but it remains unpaid. Therefore, there is a Tien in favor of the United <br />States an ail property and rights to property belonging io this taxpayer for the <br />amount of these taxes, and additional penalties, interest, and costs that may <br />accrue. <br />Name of Taxpayer <br />Jan Rojewski <br />Residence 1310 North Hancock <br />C~and Islandr NE 68801 <br /> <br />Kind ~ Tax <br />Tax Perkx! Ended <br />Date ~ IYSSessment <br />Idesntifying Number U~sld >! <br />at. <br />(e) 161 (el ~ (dl rl <br />6671-17 <br />I 8009 03--03-~a1 ~ <br /> <br />s <br />i <br />i r~ 5C5-3~43~ $ 7bs3't.38. <br />Ptace of Fihng Register of Deeds <br />Ha12 County Totai S 7b67.38 <br />Grand Islands NE 68$01 <br /> <br />This notice was prepared and signed at _ (Wand- I s18nd~ Nebraska .66801 , on fh4s, <br />the 15th ,day of 1~Sarch t 9 81 <br />Signature~~-~~~_- ____ Titie <br />(NOIO: Certiteeate of or/rce~ author~zaU by taw ro taka acknawfaQ9ments rs not essential to tlw;~ viUWTy._ of. Natlw_~-o1,_ <br />Fetlerel Tex Leen G. C. M. 2CW 19, 195-1, C. B. 125.) <br />Part t - TO b6 kept by rscordatg offke/ l=0rm 888 iRev. &78T <br /> <br /> <br />~- <br />