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F«m ea8 o~~ert a n~ ~niu~r - wreral ~EVaiE af~ Fa Opriona/ Use Br Rsco~di~ 01Yire
~A~r. z•»~ NOTICE OF FEDERlit TAX tiEN UNOER IMTERNA~ f~YfNBE LRWS
D~~p - SEAIAL NUMBER aT
LUCIE CQUNTY f~~
JA~~SONV 1 LLE ROCER POITRAS ~
CIERK CIRCUfT CO
Pursuant to the p~ovisions of Sections 6321. 6322, and 6323 of the Intemat Revenue ^~[P.~FIEO
C.ode. notice is hereby given tt~at there have been assessed ur~de? the Intemal Reve-
nue laws of the United States against Me tollowing-named taxpayer taxes (inNuding APR I1 IO OS ~M ~~8
mterest and penalties) which aher demand for peyment thereof remain unpeid. and
that by vi?tue ot the above-mentioned statutes the amount oi said taxes. togather with
penalties. interest. and costs that may eocrue +n addition thereto. is a lien in favor oi
the United States upon all property and rights to property belong~ng to said taxpayet.
NAME OF TAXPAYER
RONNIE J. ~ RYNA I. HEADRICK ~
ZV ~y-~~~0
RE&I~E NE TTSTH ST.
6 6
MIAMI, FL. 33161 ~ ~
U~IPAID BALANCE
KINd OF TAX TAX PER100 ENDED DATE OF ASSESSMENI IDENT1fY1NG NUMBER QF ASSESSMENT
la) IDl Icl . !d1 le)
1040 12-31-75 03-06-78 457-62-2991 ~ 1,008.80
~
PLACE OF FILING CI.ERK, CIRCUlT COURT _
ST. LUCIE COUNTY TOTA~ S 1,008.80
FT. PIERCE, FLORIDA
WITNESS my hand at Miami, Florida , on this.
~ l 7th day of ~ rch ~ 9_~$ 6CQK ~V5 ~AG` Jll
SIGNATU TITLE
`Y REVENUE OF
NOTE Grtd~ra:~ o: oHKSr suMorr~ed br taw co ~ats sckrwwt~dpmsnrs rs raf esssnt,~t to iM vaYdity of Not~u o( F~dersl Tax l~+ G.C.M
28~ 19. C.B. /950 t' 2 5.1 .
PART 1- To bs rstai~led by recording ottiCs
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