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Form 668 U S TREASURY DEPARTMENT -~nTEkr+~~ aEVEr+uE sErtv!CE Fo. Opr:wwl U~ e~ R~co.~ y~I•ce
REv. $-571 NOTICE OF fEDfRAI T~X t1EN UNDER iMTERNAI REYENUE LAWS
DtSTRIC~ SERIAL NO. S~
CAE C UN! T.'
`~A:7
Pursuon~ to the provisions o( $ections 6321, 6322, ond 6323 oi the Internol Reve- R~Cn~ V~ERIF~ED `
nue Code, notice is hereby g~~en ~ho• there hove been asse:sed ~nder the (nrernol ~a7~Q8
Revenu~ lows oF the United Stotes ogoinst the following-nomed toxpayer, toxes q!
(including interest ono penolties) which ofter denand For poyment thereoF remoi~ ' 0 SEP 22 PK ~•(~J
unpoid, ond tF~ot by YIfTUQ o( the obove-msnl~oned statutes the amount of so~d taxes,
togeth~r with penol~~es, ~nterest, and costs that moy accrue ~n add~~~on thereto, ~s
o lien in iovor o( the U~~~ed Stotes upon oll prope~ty and r~ghts to property belong- fl~GER ~Q~TKAb
~~9 ~o :o~d toxpoye?. CLERK CIRCUtT COURT.~
NAME OF TAXPAYER
HICK.ML C ~ ~ZABg'II~I J RQSSON
RESIDENCE
5298 NORTH lOTH STRI3h'T
FORT Pr~RCE, FLCRIDA 33450
CLASS OF TAX UNPA1~ BAIANCE
?o: Return Form No.1 PERIOD ENDEO ASSESSMENT DATE IDENTIFYING NUMSER OF ASSESSMENT
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°LACE OF FIL~NG
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S~GNATURE TITIf •
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(NOTE~ C~•r;iicaq oF olFicr~ ou~hor~?r.iy.iorr+rtok• ackno«ledqm~nts is not •fse~t~ol rp tM val d~ty oi Nohc~ of F~d~ral 10~ ;.i~~ Ci.C.M.
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aoo~187 ~c~ 647
PART 1-To be r~tain~d by recording offic•
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