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- fOrtn ~~ W~ •. _ Department of the Treasury - totarnel Revenue-9ervke <br />(Raw.September16T87 ` ~<Nd~ice'o"~ F@d~'dI Tax Lien Under internal Re~nue l.~n" <br />{ <br />f~istrict 9arlai 1Vumbet F .• aprfanAt;Use by Rsoorewl0 27I~Naa <br />~A~R ~r"~ :. 38583 <br />!•tis provided by;sbgs'ktfts' w'1'i.. iB2. and 632°ot flee fnterrtal Revenue Code, <br />ntldee i;r:_givef! That taxes (igclyding infe+^est and penalties) have been assessed O 7 r~A r~ ~~ <br />eg81r1strtfhe following-Warned taxpayer Demarxi for payment of this liability has ~~.2 ! vG <br />heM'f tnape, but ft retnain$ unpaid. Therefore, tliste is a lien in fever of the United ~ <br />SYBtes cn alt property and rights- t6 property t~tonging to this taxpaye( far the <br />arttbunt 1N these- taxes, and additional panellise, interest, artd costs that may <br />acoiue: <br />Nathe of Taxpayer <br />Tea~sy D. IwarLSld <br />ZteiBneki Body Shop <br />Residertre. <br />- Route 1 Box 2b <br />A'_da, Nebraska 6$&10 <br /> Unpaid i3alanCe <br />Kk~d a! Tax Tax Perbod Ended Dais of Atnsarnant IderNfFying Number of ' <br />- - ra) " ref (W (dl (sY - <br />941/oi -6003 06-16.0 47--0616450 ~ g2.g0 <br />941 61746 11--03~0 47-~b1b450 ~' 406.17. <br />9f{,1/01 8012 05 25-61 47-Ob1b450 $MF 1,068.60 <br />9/c)/10 8012 03-16-81 <br />I <br />i <br />i i <br />~ ~ 47-Ob1b450 ~ 66=.05 <br />~~ or rtu~ Register of Deeds 3 <br />~tY' °f ~- Total i Sl, 657.72 <br />Grand is3a~xt~ Nebraska 68$01 ~ <br />Tttls ttvt=+ ~d a~i si8ned-at _ Grate} Fa~aru3~ Nebraska ~ ort this. <br />,t9 81 <br /> <br />~~~~ ~ i Title <br />1!Y D, Met {/ Revenue Officer <br />(Mqw Certiticarr of otlicer authorized fly tur ro rake acknor.foo4manta ,3 not sss~nda/ to tM vµaity of Norlcs or <br />fsdwrat Tu Liert O. G. M. 29414, 1460-t, C.B. Y2&) <br />Part t - TD is tWPt by recott~tp oaks , Form 668 {Rev. &78) <br />i <br />a <br /> <br />