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<br /> <br />§. FgT11 ~~, <br />) <br />i <br />(Aps'.asateinik <br />Oegsstiment W thta Tfesaury - intnmst RWOflUB Suvke <br />of ~eder~l i'ax Lien Under Bn#ernal Revenue Laws <br />i~atiiCt Seriat Number Fw Ophom/ fNtt Dr AeoorWnp OIHCv <br />~ 47 39721 <br />Rs provided by soa:ons tK321 6322, and 6323 of the Internal Revenue Code, 919 <br />note F3°givers that taxes {inauding interest and penattiesl have been assessed ~ ~ j ~ 5 <br />~j 5 <br />ege:nst dee foNOwtng-named taxpayer. Demand for paymet9t of this liability has O 1 <br />been matfe, but it remains unpa~. 1-herefore, there is a lien in favor of the UnMed <br />States on alt propeRy and rights to property belonging to this taxpayer fa the <br />am~nt of these taxes, snd adtlitional penaitfes, interest, and costs that may <br />accrue. <br />Name of Taxpayer <br />David R. Staith <br />d/b~a Satith Sign Company <br />Resident:e <br />604 South bfebb Road <br />41;t~• Nebraska 68801 <br />Kind of Taft Tax Period Ended t]ate of Assestna+dttt Idsttdlying Numbsr ot~Atss~ment <br />GJ (Dl !cJ !m (q <br />911/®1 ~ Bt31z o'7-Ob-Si 1~' 47-059T777 z-ob7.94 <br /> <br />4 v"/-~~3"i i6.~ <br />- ~lu4CR 4J{ Fa,i~ 1,~ <br />t~unty of Pistil.]. Trttai { 3 zro84r01 <br />C^rarrt Islandr Nebraska 68801 ~ <br />1 _ - <br />7'ttls notice was prepared and signed at _ t#rarr<i Islands Nebraska <br />~ lt3th day of Novetnbar , i s ~ <br />1 <br />L.__ <br />on this, <br />-r ~~"~"'~~? ~ Revenue OfYicer <br />_ itilfiams, Jr.r .~/ <br />C„tiAC.N of oMICy authmy~.~oy l.w to uk~ eEknuwtMypmwrtta m !poi asssntla to th0 vllltlgy of NoHCr a <br />fi~i I.1fM O.G. Bi, 2Mfs, tYSQ-f: C, B, t26.) <br />Part t - To be kept by rocording office Fwm Qtii itiev. 9.79) <br />1 <br />' `-~- J <br />i <br />~.__. <br />