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F°n" 668 OeWRment of the Treasury -Internal Rwsnue Service
(Rev. September 1978) Notice of Federal Tax Lien Under Interne! Revenue laws
District Serial Number Far thtio»at Use by Recordirp Ottic•
Jacksonvi7ler Fl•
As provided by sections 6321. 6322, and 6323 of the Internal Revenue Code,
notice is given that taxes (including interest and penalties) have been assessed
against the following-named taxpayer. Demand for payment of this liability has FILEp'AND RECOROEfl=
been made, but it remains unpaid. Therefore. there is a lien in favor of the United S'. L~JCl;: LOUhT-Y;'.FLA
States on all property and rights to property belonging to this taxpayer for the n F t} ~1 c n t F ~ E D .
amount of these taxes, and additional penalties. interest, and costs that may 4~A ~r7
Name of Taxpayer 79 ~ Z s ~ ~ 3 Z
John & I~~ucirie Robirzsonr Jr. ~
Residence 300 .~ssex Dr. CLERK C~RCUI? COURT
Ft. Piercer Fl. 33450 ,
Unpaid ealar~ce
Kind of Tax Tax Period Ended Date of Asseaslnent Identifying Number of Asslesstnent
~ [a) [D) [W [d)
i
i
1840 1a-31-?6 1-I-79 261-4~-3496 X49.55
i
f
E
Place of Filing
Clerk of the Circuit Court
St. Lucie County Ccurthoase Total = 649.55
n Fort Piercer F1. 334,50
r
This notice was prepared and signed at Fort Piercer Fl• , on this,
x
the day of ,19
a Si ure Ray Salyer Title
:revenue Officer
e: Cartlf' ate of oNicN uthorized try law to take acknowt•OpmMts b not essential to tM vatWlty o/ NoN¢• 01
1 lax Lien O.C.A~I. 2 , 1p54t, C.B. 125.)
Part 1 - To be kept by recording offi~~~ ~ 668 tRev. 9.78)
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