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ADAMS COUNTY, NE
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INST.NO.~flo8n444
Date ~?-y 09 Time •' s
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REGISTER OF DEEDS
RESERVED FOR REGISTER OF DEEDS RECORDING SPACE
ADAMS COUNTY NE
PAGE 1 OF ~ PAGES
Q2%U9/2UJC3 !3014 1~:5> I'AY ;02 4?i. 4~!'~9 liC:'. :~EC'riF,^A':2Y CP STAiS ~-; A:ialns
`~ 19 2 4 ~~ .__._~
D<~partment of the Treasury -Internal Revenue Service
dorm 6b8 (Y)(e) NOLACt', O$ ~et~CPB~ ~dX LI~1'!
CRev. February 2004)
Area; Serial Rrumber Far Ur:•ticnai Uss by Recording Offion
SM.~1LL D7Ja`I?JEr3S/SEL•F EMPLOYiab .A.AEA #9
Lien Unit Phony; i90ot $«9-39i1i 41739:408
ne sec of sta<* ,rnnr. H ~sa:c - ~cc ~r
As provided f>y section 6321, b322, and 632 bf flee Internal Revenue ~~ (
Code, we are giv[ng a notlse that taxes (including interest and penalties) I
have been assessed against the foltow[ng Warned taxpayer. YV'e have made
a demand. for paynfent Af tfris liability, but it remains unpaid. Therefore, ~
I
.there is a Ilan in favor of the United States on all property and rights to I
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gg08546490-9 Rgs: i
property belonging to this tarxpayer for the anrotint of these taxes, attdl CLINE EUReR' L
addiiviana[ penaities, interest, and costa that may accrue. Filed: 02/04/?009 11~5fi RM
PJarne of ~faxpayer :GUR~tA L ~ I;AJR.A L CLI~~TB
Residence 2:040 5 i3A1,7"I~TUR7= AVE
AYRr D3E 68325.-.2602
IMPORTANT RELEASE tt~lFeTRMATt®N: Fer each assessment listed below,
unless notice of th~a lien is refi?ed by the date given in coiurrrn ie}, this notice shalt,
on the day foi(owing such date, o~rats as a certificate of release as defined
in IRC ,fi325(a}.
Tax Period Date of Last Dayy for Unpaid l3atance
Kind of Tax Ending identifr.ir~g ?dumber Assessment Rattling of Assessment
(a) (b ._. C) (d) (e) ~ (~
1040 12/31/2004 X~-:Xk-7453 05/30/2005 06/2/2015 34.2. L3
E
Place of Fifin~;
Registrar of ;'eeds
Adams ~ro>'itt~y Total $ 342 . ~3
~Iasf: togs, NE 68901.
This net±cv was prepared and signed a" _____-_-5 "' PACSL, MN -__-, on this
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,
the 24t;kI. day °', _`'``I~u_~;y - -20rJ8
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y
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O y~`L~ ACS 24-00- 0008
for REGINA
WENS {800) 829-3903
(TIOTEi Certificate of officer authorised icy lativ to tape acknowledgment is not essential to the validity of Notice of Federal Tax,lien
Fxev. Rul. 71-4(i8, 1371 ~ 2 C.B. ,atlpi
Part t - Kcpt lay Recording ofi'rce Form 6b8(Y}{t) (f~ev. 2-ZOO41
CAT. CJC 6'J025X ~.,.
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20080444
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