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~wm ~~$ , Cwnartmwnl at tfi4 Treasury - Itsterr+el Rsvxnus SBRYCii <br />I~ww.~~~„Q,~,g,~ ~'ot ~f Fed~r~i Tax ~i~n Under Ir~ter~a! R~v~r~ue La~r~ <br />_....____.__._._:_.f___.~____ ___, <br />33estrict Barret Numtser _ ~ For ut~tlnrnt usw by Rsawdlny arrws <br />~ 38334 I <br />As proviated by sections 8321. 6322, and 8323 of the Internal Revenue Code, I <br />notice i5 given Etter taxes {irtclutlir~} interest and penalties; have been aase.,sed <br />against tYte fdlowing-named taxpayer. pemartd for payment of this liability has <br />F.m~q ,. ~. ~w It r~±tal:u €;,rsp-s6,, r?~•~fc~. ttl~° ~ v lien in feuar pt the 11rsited <br />States on ali t3sapasty and rights to property Ex31o wing to ttsis tar:ps^yer far the <br />amtwnt of tltesa taxes, artaf addHiona! pet[elties, interest. and costs that may <br />$~ I <br />Warne of Taxpayer d <br />Grand Island Lasat Care Inc {a cor~orationj i <br />222b S 3lsine <br />Grand Islandr tdPbraska +8801 <br />Kaed ~ Tar <br />fat <br />4G.1 - O1 <br />Tax Period En:3ad I Dati W Awanstattt <br />j ,2. rr,3 <br />12-31-80 03-15-80 <br />s <br />3i+sgi.asc.~r o~ ~ -;u~ <br />atuxty of fia71 <br />Uratui Is2attdr Paebraska oc;.302 <br />Total ~ ~ 4r 122.00 <br />7ttts nati~s uses fxAparad and signed at . srand_ I~Isnds__ hebraska_-_---_--- - -- _ ,___--- _ , on this, <br />the_~. 6th dFy of A~'~_. ,1 S . 3I <br />Signature ~ ~ y -~ --' Titre <br />H G Mcihi.lliams Jr X,-- Revenue Officer <br />IMe!!t: Cpxttxsta of oltscer awtmsiand F:y + w ro ra.a artn+nrtwdyn+~nts a not raasMiN fo cM rW9k~y, 00 Ny(b~. 8-. <br />twavrz+r Tsa Z+sn 6.~ ~. zN.+~, +'/5u t, :;.&. E<53 - - .. - <br />Part 1 - Ta bo kept by recardirfg Ottbe Fixna tiAE fRav. 6~Ttt} <br />r... <br />~~..a..oQ 1(3~p <br />!~ MuenGer <br />td1 <br />«7-aS55093 <br />sat <br />td <br />1«i 122.00 <br /> <br /> <br />