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" ,~ <br />7 <br />i <br />,. ~ ~I T$7C Lin U~~r l~~~~ F~:~n~ <br />-- <br />{3mstta _. 47 ~ 34510 <br />~ provided try sections 8321. 8322, arm ~i23 of the intemai Revenue Code, ~ <br />no~;e i~ given tt~ taxes finduding interest arm penalties) have !assn assessed i <br /> <br />Wit" rile ffliiowing-rtaalec! taxpayer, Dee+artd for payment of this tiabiiify has p <br />p ~ --- #} {~ <br />taeen made. 6aatst remains unpaerl. Tfterefona, there ~ a lien 'sn favor ~f the United t <br />Stases oh alt property and rigtrts to properly wing to this taxpayer for the <br />amount of ttte~ taxes, and ~Ciitionai PertatS~, interest, and costs the may <br />accrue. <br />fMarrre of Taxpayer <br />f~a3sd Islattd Iatm Care Incorporated (a corporation) <br />Re~darrce <br />2226 3atzth Blaine <br />ft~and Islandr Nebraska 68801 <br />KYtd of tart Ta: Perioa Ended Deb of /wamaaru tdarMirybq Wumbe. ~/Iaraaart~wre <br />r+a a„ ra rm rr <br />'943 -- 03 8306 09-34-81 Btu' 47-05551)93 8,244.46- <br />teoCFiih~p Rei~ster of Dee ds <br />fosaitg of Hall. <br />f~a±xf: Ial~ndr Nebraska 68801 <br />Total ~ >~ Ss~+k•46 <br />TiWt:.n1>t#~a w~`Rfapar6d and signed at ~~ Islands Nebraska , on this. <br />ttte 8th day of October ,19 81 <br />-•~--f'4 iRr~ <br />tme <br /> <br />(NOIOe CMNfaete of exrmsr ®utt,ostsw or t.w ro n1c~ +ctv<Ow~rtrenh to trot •sent(tt eo- tM-velMRte. a xaiee w <br />rveat ru wn o.c.rN. seta resat, as. rss.a <br />Part 1 - To tw kaACby raoordhg ollice~ Form till fRev. a~81 <br />i <br /> <br /> <br />