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! <br />f <br />,,~ ,. - - - <br />~~ i - - [hgaAm+art of Phe'Trv».>rry - iMlPtiE1 R6v1a'nue Ssrvic9 <br />FCMG~J <br />~'O~ t~.i*s7iTr~ ~ ~- ,.{~~ Tai Lin 'Ur In~emal ~ Laws <br />[ ~ i ~`Brtaf-fYYil7Sb@f ~ FOf QptlORlf Stss by RxwQt+p 6fi7es <br />1 i <br />~~ 47 39124 <br />fle grovided t1y s4x:ti0ttS &;i24, 8322, arsd 8323 of the trrtemai Revenue Cow, <br />nottt~ t>s giden ttsaf i$xBS fsr+dudhrg interes! anti penattiesl have been assessed <br />~ ~e fang-name€i faz#fay8r. Qetfsand !or t~aYment of this iiabitity has ll <br />teen m~e, but itrematns unpaid. Tta~frn+a, th8te is a lien in favor of the United I p ~ ~,,,~~ ~ i ~ ~ rt <br />Stags an aft property and rights to property belonging to this taxpayer for the O <br />amaunt of tPieSe texas, and additional penalties, interest, and costs that may <br />accnae. <br />Name ~ Tsxpairer _ _ _ _ <br />i <br />C~t~ Island I,stm Care Irscor4aarated (a corporation} <br />Reatdence __._..._.~~,.._ i <br />2225 ~otxth 137.aine <br />ttr~d Ia'ilutd~ . ~et~rasira S~Oi <br />IUgdd Tea ' Ta: Poriod lcnded ' Seta ~ Asm~atient ~ {dsnittYk~p Number <br />;u I :a~ <br />(+) fi 1b k <br />Ski ~-• 01 ; 8103 ~ 0'7-iX~-81 ~ ~4P k7-0555093 <br />oe AssewaeaE <br />(.7 <br />2,9b7.2b <br />fsta>rce of f~ Etegi,ertex~ ~£ Deeds <br />rs~~~ of iial2. TEit~ # ~r9~+~.2ti <br />r-~.~y~ t=}wit i4i,y-fig ` ~i <br /> <br />Tt~ ratttfe51 end egneo as . _._ ~Illtld ISl~. Nebraska .._..._ _ _- ~~~ . on this, <br />_21at oay of .. At~uat _ , t 8 _.__~?~-___ _.___ <br />`Title <br />fZevenu8 t?~~icer <br />MOh1: CwPatrcaa M o+ticst at~tho,~zaQ .hy 7arr to tak. acMnowlWpmwitt ,s naf YaillniN7 ro !tW vlfptilM W NG+G. W <br />F.wrs7 ~.. tan u.c.+w z6a7u. ru5a+,c.c+. +tal <br />Pert 4 - To be kept by recordong office dorm @Ild,i~av. 578) <br />~' <br />s~ <br />• l..__ ___.J <br /> <br />