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4-43!634'7 ~
Form Department of the Treasury - Internal Revenue Service
(Rev. Septeml>er19T8) Notice of Federal Tax Lien Under Internal Revenue Laws
District Serial Number Fa optional Use Dy Recording oni~e
Jacksonville Florida MAY -9 PK 2 43
As provided by sections 6321, 6322, and 6323 of the Internal Revenue Code, ~ p.
notice is given-that taxes (including interest and penalties) have been assessed ar01A
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 Ri:CO[t6w'ERtt'tE0
States on all property and rights to property belonging to this taxpayer for the
amount of these taxes, and additional penalties. interest, and cysts that may A A ~,7
accrue. ~3`:
Name of Taxpayer
Rita A. Lavin
Residence
P. 0. Sox 665
Fort Pierces Florida 33450
Unpaid Balance
Kind of Tax Tax Period Ended Date of Assessment Identifying Number of Assessment
(a) 1b) lc) (d) (e)
1040 12-31-75 05-31-76 264-24-9418 124.55
1040 12-31-77 06-05-78 264-24-9418 955. Q3 '
i
l
Place of Filing
Clerk of the Circuit Court
St. Lucie County Courthouse Total = 1079.58
Fort Pierce, Florida 33450
I
This notice was prepared and signed at Fort Pierces Florida , on this, ~
the 8th day of ~Y ,19 79
Sign re Title
R,venue Officer
ote: Ca iticate of oftieer thorized by Mw to take acknowledgments is not essential to the validity o/ Notice o/
ral Taft Lien O.C.M. 2 18541, C.B. 1?5.) ~~~{{~~~j '1( .
1 - k t recording offfce~ ~j Form 668 (Rev. a76)
Part TA be ep by ,