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form 658 DEPARTMENT OF THE TREASU~!-WTERVAL REVENUc ~ERVKE For Op~ori e
~RkY. i-70) NOTICE OF FEDERAL IAX LIEN UNDER INTERNAL RfVENUE LAWS CIERK CIRCUtT COURT
DISTRICT SERIAL NUMBER RECORO YERiF1ED
_TA(:KS(x,NTT_i_~_ _F~['RTM OCT IS a ~4 PH ~7t
~'~~suant to the prov~sions of Sectic:~~s 6321, 6322, or?d 6323 cf the internol Reve-
nu~ Code, not:ce is h~reby given ihal there hove been assessed ~nder the tnternoi
Re::nue laws of the United Statez against the following-nom~ taxpayer, taxes:includ-
ing inte~est ~r ~ pe~ohies) wh~ch aker demand for poyment ti~ereoE remain unpaid. ond ~4U106
thct by virtue of tne ^bove ment;oned stotutes tt~e omount of stiid taxes, together with
pere:?~es, interest, and costs thet may accrue in addition il;ereto, is a lien in favor of
the l;nited Stotes upon a!! property ond rights to property betonging to wid roxpoyer. .
NAME OF TAXPAYER
Roosevelt Duncan
Duncan Maso ~ -
REStDENCE
1904 North 16th Street
Fort Pierce Florida 33450
" ~ UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDED ASSESSAAENT DATE IDENTIFYING NUMBER OF ASSESSMENT
~d) - (e1
941 Withholding 06-30-72 09-25-72 59-1168437 $ 1,0p7.05
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PIACE OF FIUNG
C1erk, Circuit Court TOTAI t 1,007.05
St. Lucie County
Fort Pierce Florida
WITNESS my hand ot West Palm Beach~ Flnr; c~a , on this,
°~~x 20? ~-1~9
the 12th day of October , 1972
~ /f~ ~ Q_.
SIGC. R / .~~'liLr-f/~= y T1TLE
C L HFACHEt~iAHN ACTING GROUP SUPhRVIS~
j (NOTE: Certificate of off'icer authorized by law to toke ocknowledgments is not euentid to the validiy o4 Nofice of Fedcrol Tax Lien G.C.M.
' 26419, C.B. 1950-51, 125.~
I Pa~T ~-To b. retaMed by r.co~n~ o~ce
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