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_ 439'799
Forth O.partm•nt of ih• Treasury - MtemN Rw•nus 3.1vic•
tA.~, s•ot•mo•r1eTa, Notice of Federal Tax Lien Under Internal Revenue Laws
District Serial Number Fo. optlottN us. ey a.codrto o1f>c•
Jacksonville 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 : FIE~pL~AND' RECORD
against the following-named taxpayer. Demand for payment of this liability has ST. IU~IE CCUNTY;~'1:A.
been made, but it remains unpaid. Therefore. there is a lien in -favor of the United l%~CpRD VEF~1KtE`b
States on ail property and rights to property belonging to this taxpayer for the 4799
amount of these taxes. and additional penalties. interest. and costs that may
accrue. yt9 APR y ~ ,2 ; 37
Name of Taxpayer ~ ~ h
Richard C• & Rosemarie i•;. Thomas T
ROGER POi: Rt.~
Residence CLERK CIRCUIT COURT,
453 Ssabreeze Lane
Port St. Lucie Florida 33450
Unpaid Balm~ce
Kind of Tax Tax Perbd Ended iDats W Assessment identifying Number of Assessment
N) fD1 [o) (d) W
lOl,4 1231-?6 1~-02-78 311-1~-2b1~0 1~ 181.03
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~ Place of Filing
~ Clerk of the Circuit Court
St• Lucie County Courthouse Total ; 1,181.03
Fort Pierces Florida 33450
This notice was prepared and signed at Fort Pierce, Florida , on this.
s the 4th ~y of Aril ,19
t
Si atur Title
Revenue Officer
C•rtif t. of of/icav • iz•d by law fo qk• acknowladpm•nta h not asiattia/ to th• raUdlfr o/ Notie• 0/
Tu Lksn Q.C.M. 2611 5t}f, C.B. 126J (j ~ `'yin
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Part 1 - To He kept t7y recording office Form 668 (Rev. 978)
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