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Fo~m 668 OE?ARTYFNl Of 1HE TREASURV-INTENNAL IIEYENUE SERVILE For ~tiOnal Ufe BY RCtordrng O~IiC! t
IREV. 1Z-711 NOTICE OF FEDERAL TAX LIEM UMDER INTERNAI REVENUE LAWS ~ ~
DISTRICT SERIAL NUMBER
Pursuant to the provisions of Sections 6321, 6322, and 6323 of the I~ternal Revenue ~A '
Code, notice is hereby given that there have been assessed under the Internal Revenue laws
of the United States against the foflowing-named taxpayer, taxes (including interest and
penatties) which after demand for payme~t thereof remain unpaid, and that by virtue of
the above-mentioned statutes the amount of said taxes, together with penalties, interest, -
and costs that may xcrue in addition thereto, is a lien in favor of the United States upon i
all property and ~ights to property belonging to said taxpayer_ _
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NAME OF TAXPAYER ~
Freeman Davis
RESIDENCE
P.O. Box 191I
Fort Pierce, F1. 33452
UMPAlD BAIANCE
KIND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
la) Ibl lcl Idl (el
1040 I2-3I-72 04-14-75 265-20-245? 1606.87
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PLACE OF FI~ING
Clerk, Circuit Court .
' St. Lucie County TOTAL S 1606.87
Ft. Pierce, F1.
WiTNESS my hand at Orlando~ Florida
, on this,
the 2lstday of Sept. , 19 ?6
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SIGNATU TITLE
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Revenue Officer
(NOT - Cnt~ficaf offrur ~uthoritW by law to tNc~ acknowl~dyrnMts is nOt ~isMtial to tM v~lidi~y ol Notiq of FW~~M TVt I.wn (3.C.M.
26~19, C.B. 195 ./25.1 ~oOK~~ p~~ A`~ _
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