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Fa~m 668 OEMIITMEMT Of TME TIIEASURY-IMTE~NAL REVENUE SERVICE : FOI ~[ipu/ f/ts By RICWdiny O//i0e
~RE~• NOTICE Of FEDERAI TAX LIEN UNOER INTERMAL REVENIIE IAYMS ~~0 ANL+ ~lE~,Q R
DIST 1 T ~ SERIAL UMB R WC~E GOYIITY
ftOdER o0lTNA~
ClfRkspU~~~T COUAT ~ ~
Puawnt to the provisions of Sectio~s 6321,6322, and 6323 of the Internai Revenue FCaR ~ Y.• •FiED
Code. notiae is hereby given that tfiere have been assessed under the Intemal Revenue laws i ~ ! ~
of th~ United States against tha fol{owing-named taxpaye~, tsxes (including interest and ~1 I~ 39 PM 15 ~
penalties) which after demand for payment therQOf remain unpaid. and thst by virtue of
tt~ aba,e-mentioned statutes the amount of said taxes, together with penalties, interest,
and oosts that may scaue in addition thereto, is a tien in favor of the United States upon ,
all prope~ty.and ~ights to property belonging to said t8xpayer.
NAME OF TAXPAYER '
Ji~y il. Conavqy
J ~ e xaaoi~y
R 32~ s~ Lane~
Port st. Lncie, ~ 33452
. ' UNPAID BALANCE
KIND OF TAX TAX PERIOD ENOE~ ~ATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT ~
la1 Ib) k1 " (d! Ie1 ;
91~1 09-30-74 02-03-75 59-111~1907 $ 2, 895.87 s
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PLACE OF FILING Clel`k Of ~CUit COU~t
St. Lncie C~y TOTAL S 2~a95.87
; Ft. Pierce, ~ 33450
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WITNESS my hand at Ft _ pierce. ~ , on thit, ,
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~ ~fie~~daY of ugv~at , ,s 5
SIGNATURE~ i/ TITLE g40K ~.r~~ PACE
~ a, S, g~ ~ , aroup Kanage_r i
~ (NOTE: Cwtific~t~ of offier wthwizW by law to tdcs seknowlWyirwnts is not ~s~ntial to th~ validity of Notie~ ot FWaal Tax Li~n G,C.M.
26419. C.B. 19541. 126.)
~ PART 1-To be relained by ~ecording oFfice
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