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pam ~g ~~MTMENT QF iHE TREASUAY=INTEIINAI NEVEpiIE SEMIICE . for ~fiw~a/ fJsl Bp RaCpdiny Offipe
tpEV. ~2aa1 MOTICE OF FEOERA~ TAX LIEN UNDER IMTERNAL REVENUE~IAwS -
DIST I T SERIAL NUMBE •
3~C'~.:SONVILT.E ~ -
Pwsuant to the ovi:ions of .Sections 6321, 6322,~and .6323 af the internal Revenue E 1?N~ $ ~
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Caie, notice is hereby given that the~e have bee~ assessed ur~der the Intemal Revenue laws ~~R t81 A
u de
of,the Unitod States against the following-na~mad ta~ayer, taxes (induding_inte~est and C4[RK CtR IT Qf! ~f ~
peoalties) which after demand,for payment.thereof remain unpaid, and that by virtue of ECAl10 Vf.R~~1~D,~,.~,,,~....~
the above-me~tioned statutes the amount of said ta~es, together with penaities, interest, ' ~~4
and oosts that may acaue in addition thereto, is a lie~ in favor of the United States upon •
all property snd righu to pr~periy belongi~g to said taxpaysr. _ ~
NAME OF TAXPAYER
~,ad ~nest~ ~ 32~ 328~9 _
RESiDENCE
1 ~10 i~o. 22nci St . ~ .
Ft . Pie: ce, FI. ~31t52 ~
' U~IPAID BAlANCE
KINO OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT ~ IDENTIFYING NUIKBER OF ASSESSMENT
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9~?3 . 12-31-7~t 1-5-75 54-11 n2203 - v 12QO.OG
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PLACE OF FIUNG Cler'r. o~ Circuit C~~u~t
~ S~. Lucie Go~antQ TOTAL t ~2pp,pp
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t, Pierce, FL ~ 33lt~2 -
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~ Ft. Pierce FL .
WITNESS my hanti at ~ , ~ ~~s,
~e 23raday of ~ebruar=,~ , ~a 76
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SIGNATU TITLE , ~
G. j~
- . ~l . u~haxpe - vroup kianager . ' ~
1NOTE: Grtifipte of offiqr ~utboritW by ~~nr to tak~ ~cknowNdy~Mnts is ewt ~frntial ta tM qlidity of Notiq of F~d~SM Tax Li~n Ci.C.~A. ~
26419, C.B. 79541, 725.)
PART 1-To b~ retained by recora~ng office Qr~~ ~~g ~ 4~~
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