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For1n Department of the Treasury -Internal Revenue Service
(Rev. September/978) Notice of Federal Tax Lien Under Internal Revenue Laws -
District Serial Number ~ Fo. optional u:. bN aecording orrice
Jacksonvil?c +~T9 ir'~1Y -9 ~ ~ 42
As provided by sections 6321, 6322. and 6323 of the Internal Revenue Code. FtlEO AMU kEWRDEO
ST I.UClF~000t~Y.FIA.
notice is given that taxes. (including interest and penalties) have been assessed DOGE POOttiRAS
against the following-named taxpayer. Demand for payment of this liability has ttif:RK CIRCUIT COURT
been made, but it remains unpaid. Therefore, there is a lien in favor of the United RECCFO YERSiIE~_ ~
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 ~4a~41
accrue.
Name of Taxpayer
::ark .es? ey Difon, ter.
Dixon :;;,son
Residence
2310 eve ";:'r
:~t. Pierce :l. 450
Unpaid Balance '
Kind of Tax Tax Period Ended Date of Assessment Identifying Number of Assessment
la) lb) lc1 ld) (el -
I
E 941 (~-3~.7$ 04-02-79 59--1173711 488.12
941 9-30--7$ 04-02-79 59-1T73711 3,737.68
F 441 12-31-7~ 03-26-79 59-1173711 3,791.17
9t+0 12-31-7$ 04-02-79 59--1173711 364, 27
I
Place of Filing
_ Clerk :,f the Circuit Coart
Wit. iucie Cott-qty Cour`Lhouse Total = 8, 381.24
a' ~ :'ieree, Fl. 33450
;h
This notice was prepared and signed at L't• Tierce, Fl. _ , on this,
18- April 79
the day of ,19
Si Title
ileva::ue Officer
0'1 a Certlllule officer aut zed Dy lew ro lske acknowledgments is not essential to the validity of Nolk:e d
F 1 lax Lien 13.C.111. 26118, 1 1, C.B. 125.)
aQt~ *~Ct
_ Part 1- - To be kept by recording off~Ce - Form $68 (Rev. 9-78)
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