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Ol9'M1tIBIi OF n1E TI~ASIMII' - ¦IT61M41 11EyE1Na i8t111Cf fa Optional Use By Rsco~dirtg ONrce
leEV.i6nt NOTICE OF FEDERAL TAX LIEN UNDER INTERNAL REVENUE LAWS F~l.E~ AND R~t,'ORDEO'
DISTRICT SERIAL NUMBER cam, ? l.1Cl~ COUNTY, FLA..
Jacksonville ~ ? n t t F~ E r_~
Pursuant to the provisions of Sections 6321. 6322, and 6323 of the Internal Revenue0530
Code. notice is hereby given that there have been assessed under the tntemal Rave- Ate
nue Taws of the United States against the folbwing-named taxpayer taxes (including• ~~r~ ~ 2 w•t ~ ~ 5
interest and penalties) which after demand for payment 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 accrue in addition thereto. is a lien in favor of - •
the United States upon alt property and rights to property belonging to said taxpayer. C L.F ~ K C : r r• ~ T ~ ; ~ i
NAME OF TAXPAYER
L.C. ~ Eliza Miller
RESIDENCE
308 N. 20th Street
Fort Pierce, F1. 33450
UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
(a! (DI (cl ldl ts1
1040 12-31-76 08-28-78 261-58-8816 1,047.44
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~ PLACE OF FILING
1 Clerk, Circuit Court
St. Lucie CDUnty Courthouse TOTALS 1,047.44
} Fort Pierce, F1. 33450
Miami, Florida
WITNESS my hand at on this.
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~ 21 a t day of Dec er 19 78
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SIGNATURE TITLE
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Chief, Office Branch
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is (NOTE: ~ t of officer ¢ed M law to aclcnowladymants nnot esssntul to tM vaMdttr of Not~q of Federal Ta• lien G.C.M
~ 26119. ~ .B. 95 -1. 125.)
PART 1 - To ty retained by recording office ~ R Qaf,E 1381
BOOK
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