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For1n Department of the Treasury -Internal Revenue Service
(Rev.Septemher1978) Notice of Federal Tax Lien Under Internal Revenue Laws
District Serial Number For Optional Usa M Recwdinp Olfics
Jackson~rille, FL ~°?9 ~'~=:~t '9 PN 2~ <i2
As provided by sections 6321, 6322, and 6323 of the Internal Revenue Code. AftA.
notice is .given that taxes (including interest and penalties) have been assessed 55
against the following-named taxpayer. Demand for payment of this liability has
been made, but it remains unpaid. Therefore. there is a lien in favor of the United ttEroRB~'ERtf?Et:---~-
States on all property and rights to property belonging to this taxpayer for the
amount of these taxes, and additional penalties. interest. and costs that may A
accrue. Y~s
Name of Taxpayer
William D & Rose M Flowers
Residence 1104 Mississippi Ave '
Fort Pierce, FL 33452
Unpaid Balance
Kind of Tax Tax Period Ended Date of Assessment IdentNying Number of Assessfnerlt
ral cep ce) td) cep
1
1040 12-31-74 07-03-78 264-10-b987 2,281.16
~ .
Place of Filing Clerk, Circuit Court
St Lucie County Total 2,281.16
s Ft Pierce, FL 33450
~3
.Melbourne, Florida ~
This notice was prepared and signed at , on this,
;
the 30th day of April ,19 79.
Signature Title
Charles M an Jr.
Revenue Officer
(Note: Ce diuf of officer authorized by aw to take acknowledgments !s not essential fo the validHy o/ Notice o1
Federal T Li O.C.M. 2ffllg, 18541, C.B ?5.)
Pa 1 - To be kept by recording go~fi
s~~ ~G` Form 668 IRev. 5.78)