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oEMlltgEllt OF THE TfIEAtiMI? - MtrelMlu ~EYEIIIE atlmcE fa Qprionel use By R ig O/liee
(a~EV.~i~in NOTICE OF FEDERAL TAX LIEU UNDER IUTERNAI, REVENUE U1wS
r:ECORCEO
DISTRICT SERIAL NUMBER _'_~C'~~ ::::~U~1TY, FLA.
JACl~90NVILIa . - - _
Pursuant to the provisions of Sections 8321. 6322. and 6323. of the Intemal Revenue ~ ~~9
Code, notice is hereby given that there have been assessed under the Intemal Reve- ~ ~ r ~ ,
nue Iav+rs of the United States against the following-named taxpayer taxes (including ~9 _ ~ 9 . y8
interest and penalties) which -after demand for payment thereof remain unpaid. and Q
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 all property and rights to property belonging to said taxpayer. - ~ K _ - -
NAM OF TAXPAYER
RESIDENCE
xt. #3 eoZ 4,51E
Ftj Pie Flrortaa 33lSO
_ UNPAID BALANCE
KIND OF TAX TAX PEaIOD ENDED DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
la1 Ib1 Ic1 141 1s1
101 12.31-?7 03.r06~-78 254,•20*1~48 $i,190.51t
I
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PLACE OF FIUNG~' ~~1,
STe UTC~ (70~N'PY TOTALS 1,190j54
~oRT ~xGa, Ana
WITNESS my hand at 1~~, _ on this.
7
the 15th. day of June _ 19 78
4
SIGNA UR TITLE _
Ac Chist Offl.ae Bsa~nch
(NOTE: Cwrtifics.a officer suttrorasd by Isw to iske adcnpw:adpntsnts rs rat Mrentiat to tM vaYdity or Notice o/ Federal Ts>< l,sn G.C.M.
26419.0.8.1950-i. t25.1
~ PART 1 - To be retained by recording office $9Dlf~ i~4',¢',~