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Form bed O~Mt116Mr oi tME 1~Atl~r - MiRerMt ~1IeNE tNY~f ior OP~ uss Br R~rordin~ Oll'
tREV_ i•»? NOTICE OF FEDERAL TAX 1lEII UNDER lNTERNA~ REYEIWE LAIMS '
~ISTRICT SERIAL NUMBER ~~~Q~
Jacksonville .
Purwant to ths provisions o~ Ssctions 6321. 6322, snd 6323 ot ths Intema! Revenue ~
Cods, notios is hsreby given thst thsro t~ave been asssssed under the Intemal Reve- ~,E~~~~
nus laws of ths United States sgainst ths folbwing-named taxpayer tsxes Gnduding ,~~4
interstt and . penalties) which after dsmand iw PsYment the~eof remsi~ unpaid. and V=~., C C=
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penaldes. inie?est. and oosts that msy accrus io addition thereto. is a lien in tavor of • . c'`~ - .
the United $tates upon all property and rights to pnoperty belonging to ssid taxpeyer. p ~1
NAM OF TAXPAYER MGY I a I I O4 QN !R
Clyc~e and Catherine Smith ~
RESIOENCE ~
250~ Avenue J
Fort Pierce FL 33450
' UNPAID BALANCE
KIND OF TAX 7AX PERIOD ENDEO DATE OF ASSESSMENT IOENTIfYtNG NUMBER OF ASSESSINENT
Ia! (b1 Ic~ ldl lel
1040 12-31-76 04-24-78 263-36-3106 , $1~092.33
1040 12-31-77 04-24-78 " 1,692.61
1040 12-31-75 04-24-78 " 1~456.23
PWCE 4F FIUNG Clerk of Circuit Court ~
St. Lucie County Courthouse TOTAL S 4~241.17 ~
Fort Pierce, FL 33450
WI7NESS my hsnd at Fort Pierce~ Florida ~ , on this,
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the 17th day of MaK_, 19 7f~
SIG ' TITLE .
- Revenue Officer -
TE: C~Mic+ offioei sutAwa~d I+w ea uk~ sckiwwwOpnNnts ;s not ~qsnoM to dw vaidiq of Notia af F~d~n~ Tsx l~n G.C.M.
2/9. C.B. 1 1. 125.i _
PART 1- To be rotained by rscording office ~ P°1 ~ 1~'
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