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FOfIn 6GE OEPAIlTMENT OF TIE TRfASt1RY-MFRNK QEVENUE SERVICE Fw OpfioAOl Use 8y Recordirg O16ce
~-~o) NOTKE OF FEDERAt TAX ll~l UNDER INTERNAL REYENUE LAWS
DISTRICT SERIAL NUMBER
Pursuant to the provisions of Sections 6321, 6322, ond 6323 of the Inlernol Rev~e- F1LEQ Ah~~ 9ECOROEO
ST.~UCIE ~OliMTY FLA.
nue Code, notice is he~eby given thot there hmre been ossessed under the Internal RliGi.n r0~?AAS
Revenue laws of the Un+ted Srates dgainst the folbwing-nomed toxpayer, taxes (includ- GLERS C":U:' COURT
i interest ond alties which oRer demand for RFCf~~'1 V"F ~ F ~
ng pen } popmeot thereof remain unpaid. ond
that by virhie of the above-mentio~ed statutes the amount of said toxes, toge,~her with ~AY 3 24 i H~7~
penalties, intefest, and cosh thot may accrue in addiFion thereto, is a iien in favor of
the United States upon QN property and righh to prope~ty belonging to said taxpoyer.
NAME OF T/U(PAYER ~55~~
Roland R. Vaillant -
RESIDENCE
B~x 23, B~ue Heron Lane
Jensen 8each Florida 33457
UNPAID 6AlANCE
lCIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENTiFY1NG NUMB~ OF ASSESSMENT
lal (~l ki idl te1
1040 Income 22-3Z-?0 12-28-?2 046 09 8840 S 1,153.24
i
i
~s?cE oF Hur~c
' Clerk ~ Cf rcuf t Court TOTAL = 1~ 153.24
St. Leicie County
Fort Pierce Florida
i
WITNESS my hond at Nest Palw Heach~ Florida , o„ ~,a,
;
E
~ 18th day of 1Nay , t 9_ _ 73
;
~ s~ ~tE ~ 0 R
' so~ 214 ~i~46
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(NOTE• Cerr~ficaae of oRKer aurhoraed by Iow ro roke ockrwwled9me~,~s K na esse~nd ro the ~ahddy of Notice of federd Tmc Lien G.C.M
~6<19, C.B. !950-St, 125.~
' PART 1-To b~ ntain~d br ncor~np ofRc~
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