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Form 668 C+EtJ1R7MENT Of TME TlfASl1R1~-lNTE?!VAl kfVENUE SEkVKE ~orwl use er Rcoo.d~g Ql6ce
~~~v ~•~o~ NOTKE Of FEDERAL TAX UEN UNDQ INTBtNAI REYENUE LAWS
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DIS?RICT SERIAL NU~IABER .p0. ~
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Pursuont to the prov~sions of Sections 6321, 6322, ond b323 of the Inte~nal Reve-
nue Code, notice is hereby g~ven lhat there have been ossessed under the inteinai
Revenue lows of the Uniled Siotes ngoinst the fo!!owing-named taxpoyer, taxes (includ- ~~C~
ing interest and per:alties) which a~ter demand for poyment thereof remoin unpaid. cnd v 4
thot by virtue of il~e above-mentioned statutes the amount of said taxes, together with
pena;ties, interest, and costs thot may accrue in oddition thereto, is a lien in fovor of
the l;n~k:d Stotea upon c!i property ond :igh!s to properly belon~ing to said taxpayer.
`~AME OF TAXPAYER
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- UNPAID BAIANCE
K1ND OF TAX TAX PE(L'QD ENDEO ASSESSh1ENT DATE IDENTIFYING NUMBER OF ASSESShtENT
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~ PII~CE OF FIUNG ~e* CifCUH ~OI~K
~ St Lucie County TOTAL = ' ~ ~ • ~ ~
F~ Fort Pierce, Florida
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, ~ , on this,
y< YVITNESS my hond ot
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the day of ~ , 19
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SIGNATURE T1TlE
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~NOTE: Cer~tfcate of officer ou~herized by law to ro4e eckrtowledgmenls ~s not essentiol ro the voiidity of Notice of Federal Tax lien G.C1N.
26119, ~.6. 1950-S1, 125.)
~ PART 1-To be retoined by recordinfl of~c. BOOK~O ~~uF~~~
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