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Form 668 DfPARTMENT Of THE TREASWtY-INTEo'!~l REVENUE SERVICE For Opnonol Use By Recwdng Of6ce
;REV. ~a~~~ NOTKE OF FEDERAI TAX IIEN UNDER INTERNAI REYENUE IAYYS
DISTR(CT SERIAL NUMBER
JACKSONVILLE ,
Pursuant to the provisions of Sections 6321, 6322, arx! 6323 of the Internol Reve- , 308536
nue Code, notice is hereby given that there have been ossessed under the Internol
Revenue laws of the United Stotes agoinst the following-named taxpayer, taxes ~includ-
ing interest and penolties) which ofter demand for poyment thereof remain unpaid. and
that by virtue of the obovementioned statutes the amount of said toxes, together with
pertaRies, interest, ond costs that moy accrue in addition thereto, is a lien in favor of
the United States upon all properiy and rights to properfy belonging to said taxpayer.
vAME OF TAXPAYER
William F. Gerold - ~
RESIDENCE ~
1701 Coronado Ave.
Ft. Pierce, FL 33450
UNPAID BALANCE
KIND OF TAX TAX PER10D ENDED DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
!al fb~ k) ld) lel
1040 7112 04-07-75 278-12-9758N 4,447.53
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= PLACE OF FILING CLERK, CIRCUIT COURT
= ST. LUCIE COUNTY TOTAL a 4 447.53 '
~ FORT PIERCE~ FLORIDA ' ~
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~ WITNESS my hand ot West Palm Beach~FL , on th;s,
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~ rhP 2dth day of~iaX , 1975
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~ SIGNATURE TITLE
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~ ~ Actin Grou 2•iana er
~ ~NOTE: Certificote of offic~r autbor~zed by low to toke ocknowledgmer~ts is not essentiol to the vofidity of Notice of Federal Tax lien G.C.M.
~ 26419, C.B. 1950-S1, 125.) ~~~j~(~
~ PART 1-To be retained by recording off~ce r~~~
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