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p~A~T~IT TNE TIIE/~SII~Y - MIT~IMt ~EVBIIE SfAVICE fa Optans/ Use By Recording ONite
~aev i~i~~ NOT~E OF FEDERAL TAX LtEN UNDER INTER11Al REYEIIUE LAIMS
DISTRICT SERIAI NUMBER
Jacksonville
Purwant to the provisions ot Sections 6321. 6322. and 6323 of the Intemal Revenue 4~~
Code, notice is hereby given that there have been assessed unde? the Intemal Reve-
nue laws oi the United States against the folbw~ng-named taxpayer taxes (including .
~nterest ~nd penalties) which aher demand for payment the~eof remain unpaid. and •
that by virtue of the above-mentioned statutes the amount ot said taxes. together w~th
penslties. interest. and costs that may accrue in atldition thereto. is a lien in fava of
the United States upon all p~operty and nghts to propertY be~onging to said taxpayer.
NAME OF TAXPAYER
Clarence and D~loris Terry
RESIDENCE
1601 N. llth Street~ Apt. 50
Fort Pierce FL 334~~
UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDE~ DATE OF ASSESSMEN? IDENTIFYlNG NUMBER OF ASSESSMENT
(a) Ib) (c1 idl (e)
1040 12-31-76 06~-30~-78 2b4~21~5943 $ 3b2.36
1Cr~0 12-31~7? 06-23-78 " Sb0.5o
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~ PLACE OF FIUNG -
~ Clerk of Circ~iz Cour-t
_ St. LuCie Coimty Co~;stho~~se TOTAL S 1~242~~2
Fort Pierce~ FL 334~~
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~ WITNESS my hand ac Fo*t Pierce Florida . on this,
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_ q~ 17th day of Juiy 19 78
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SIGNATURE TITIE
~ . Revenue Officer
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r, 1HpTE: Grtrf~cat~~ oN~ca~ ued by ~sw to taks adcrawledpms~ts ~s not essent~sl w tM vaMd+t~ of NotKe of Fe0KS1 Tsx L~n G.C.M.
r~ 26419. C.B. 1950-7. t25.1 `i ~~V~ 35
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PART 1- To be retained by recording ofiice
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