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Forrh DepaRment of the Treasury -Internal Revenue Service
(Rev.SeDtember1978) Notice of Federal Tax Lien Under- Internal Revenue Laws
District Serial Number For oanon,l u:e by aacod~n9 ort~e
Jacksonville Fle X19 NAY -9 PM 2 43
As provided by sections 6321, 6322, and 6323 of the Internal Revenue Code, sT 06ER 01~R~i4~
notice is given that taxes (including interest and penalties) have been assessed R ER PO!
against the following-named taxpayer. Oetnand for payment of this liability has CIRt~IT
been made, but it remains unpaid. Therefore. there is a lien in favor of the United RECORD VEftli(E0~
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 ,~4.384.~ -
accrue. -
Name of Taxpayer Robert Deborah v. Cakl.field .
Residence 9COC Y~oyal Palm ::ay -Costa ill :iol
Fort ;
isrcet T'lori da ~3L;50
Unpaid Balance
Kind Of Tax Tax Period Ended Date of Assessment Identifying Number of Assessment
[a) /D) [W [d) [e)
E
~ 101'0 1z--31-77 07-24-7g o00--!+0-O05b 1:05.39
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Place of Filing
Clerk of the Circuit Court _ _
:ite Lucie Co~,u:ty Courthouse Totaf ; 1raJ5a39
Fort Piercer Florida 33450
This notice was prepared and signed at Fort Pierces F1oriUa , on this,
- the 7th day of I•~ ,19 79
- ~g a Title
Revenue Officer
v
t: C Mute of / authorized ny !aw fo bke acknowladpments !s not essential to the wlidity oI Notice o1
~ al Tax Lien O.C. t9, 19541, C.B. 125_)
V
Part 1. - To be kept by racordirty off>l~dt!! ~V Form 668 (Rev. a-78)
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