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Form 668 Department of the Treesury - Internal Rovenue Service
(Rev.SeDtemQer1978i " Notice of Federal Tax Lien Under Internai Revenue Laws
District Serial Number Fw Opfiond Use Dy Reco~tlmq Ofhce
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Jacksonville, FL
FILEO AHC ~tCUniltD
As provided by sections 6321, 6322, and 6323 of the Intemal Revenue Code, ST.IUC~E c0!,,vtY.FtA.
notice is given that taxes (includin~ interest and penalties) have been assessed ROGER POITttAS
CLERK CIRCWT CQUR C
against the. following-named taxpayer. Demand for payment of this liability has ~ECt~QO :':Fif IEP_ ~ ~
been made, but it remains unpaid. Therefore, there is a lien in favor of the United
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
~"Je. 44'7004
Name of Taxpayer _
L C ~ Delores York
Residence Rt , Box .
Fort Pierce, FL 33452
Unpaid Balance
Kind of Tax Tax Period Ended Date of Assessment Identifying Number of Assessment
fa) fb) (W fd) [e)
1040 12-31-69 11-06-78 ' 418-42-2423 372.33
; 1040 12-31-70 11-06-78 " 994.28
` 1040 12-31-71 i1-06-78 " 2,752.24
~ 1040 12-31-72 11-06-78 " 4,604.02
1040 12-31-73 11-06-78 " 8,001.18
; 1040 12-31-74 11-06-78 " 14,431.23
G 1040 12-31-75 11-06-78 " 5,716.55
g 1040 12-31-76 i1-06-78 " 4,501.69
~ 1040 12-31-77 10-30-78 " 344.22
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~ Place of Filing Clerk, Circuit Court
; St Lucie County Totsl = 41,717.74
r Ft Pierce, FL 33450
~ ~This notice was prepared and signed at Melbourne, Florida _ , on this,
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~ the 1 s t day of June ~ 9 79. -
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~ Signature Title
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~ G. A. Sharpe Revenue Officer
(Not~C C6sfilka~s O! olficer ~uthwize0 by taw to 1~ke ~cknowledymenfs ft not assenta/ fo tAO valiOqy ol NoNC• ot
i FoWn/ T~at U~n O.C.M. 2611 ~ t DSd 1, C.6. t 25. ) a R~(~ ~r~
$ Psn 1- To ba kept by recordiny offlC~' U'^~ Form 668 (Rev. 9-78)
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