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Form 668 Dvpartmo~t of the Treasury -Internal Revenue Service ,
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tRer.S::utember,978. ~ Notice of f=ederal Tax Lien Under Internal Revenue Laws .
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? For Opt~onaJ Use by Reco:d~:•9 Onc~o
District ~ Serial Number ~ _
----'919 JUG 19 A~ 3~ ~ 3
_ JACKSONVILLE '
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As provided by sections 6321, 6322, and 6323 of the Internal Revenue Code, ST.IUCIE Cl3UNTY.FIA.
notice is given that taxes (including interest and penalties) have been assessed ROGER f'OITRAS
against the following-named taxpayer. Demand for payment of this liability has CLERK CIRCUIT C
been made, but it remains unpaid. Therefore, there is a Lien in favor of the United RECCRD t't;"IF!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 448•~p3
accrue. aa~~vv
Name of Taxpayer
HARRY 1:. & ELIZABETH t~DOIIALD
Res~dence ` '
1.10 Chipola Rd.
Ft. Pierce, FL 33450
~ Unpaid Balance
Kind of Tax Tax Period Ended Date of Assessment Identifying Number of Assessment
{a) (D! fc) rd! lam)
1040 12-31-7v OS-2E-79 402-GS-2733 1,063.93
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Place of Filing Clerk of Circuit Court
St. Lucie County Tf~ef s 1,063.93
Ft. Pierce, FL 33450
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Y This notice was prepared and signed at _ iielbourne, FL _y , on this.
the 7th day of June . ~ g 79
Signature Title
(Notar: Certd/cafe of otlrcer euthorizsd law to take acknowfedymenfs is not essential to th9 ratidiry o/ Noticra o/
Fodera/ Tar Lien O.C.M-28It9, tsa54t, 125-) Q ~
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Part 1 - To be kept by recording office Form 668 (Rev. 9-78)
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