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Form 668 OEPA1ttrNENT OF THE RE~WJmf-wTE4rtA1 lEVENUE SErcvICE ' For Oprand U~e By Reoordnp 016ee
~r~v. i-~o~ NOTICE OF fEDERAt TAl( LIEN UNDBt INTERNAt REVENUE IAWt f~EO ~?My ~ f t~K~p
i~~ ,t Gs3u~T1' ?t,A,~' ~
DISTMCT SERIAL NUMBER 1lOG~r ~ )11RA; ~
JACKStkiVILLE ~IE~iK ;,::'~yl100URT
RiCrRO VE?~~lE~
Pursuant to tt~e provisions of Sechons 6321, 6322, ond 6323 of the Internai Reve-
nue Code, notice is hereby given that there have been assessed under the internal 2 26 1 fl
Rever.ue lows of the United States oyainst the following-named taxpayer, taxes (includ-
ing interest and penalties) which ofter demand for payment thereof remain unpoid. and .
fhot by virtue of fhe above-mentioned statutes the amourst of said taxes, together with
pe:?olties, interesf, and costs Ihot moy accrue in add~tion thereto, is o lien fovor of
ihe United Stotes upon a!I property a~d righh to property belonging to said taxpayer. 2~~06'
NAME OF TAXPAYER
Hollis iicGili Johnson
RESIDENCE
1U17 ::ayflower Rd 6
FT Pierce FL 33450
UNPAID BAtANCE
KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
~a~ (d~ ~e~
1A40 12 -31-72 OG-U4 -73 264 -R"L -35 ~6 1, ~9d. 74
.
. '
Pu?cE oF F~ur~
Cle~fc, Ctrcult Court
St LuCle CouMy TOTAI s 1 096.74
Fort Pierce, Florlde '
WITNESS my hond at 24iami, Florida , on this,
~ 22st ~y of January ~ ~q 74
~,~.~q~E T1TLE
.
Chief Uffice Branch
(NOTE: Certificote of ofFicer outhorize~ by law to toke acknowledgments is nd asennd to ths volidAr oi Notiu of Fede~d Tax lien G.CM
26419, C.B. 1950-S1, 125.) O R ~E ~~Q
~ PART 1-To b. .~to~ed br record~n~ o~k• a00~ ~r~~