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Form aB8 o~asTta~tt a TIB TIB/LSIIIIY - Mrtt#MAt staleuE selntE For Optana/ use Br Recording ONice
IREV. s-»? NOTICE OF FEDERAL TAX LIEN UNDER INTERNAL REVENUE LAMB _
DISTRICT SERIAL NUMBER -
Jacksonville F1
Pursuant to the provisions of Sections 6321. 6322. and 6323 of the Intemal Revenue
Code. notice is hereby given that there have been assessed under the Intemal Rave- 199 ~ 9 A'I 3- 4 ~ _
nue laws of the United States against the following-named taxpayer taxes (including
+ntereft and penalties) which after demand for payment thereof remain unpaid. and FILED AMC hti:uHilEO
that by virtue of the above-mentioned statutes the amount of said taxes, together with !T lUC1E C01lNTY.Fl.1.
penalties. interest. and costs that may accrue in addition thereto. is a lien in favor of ROGER POITRAS
the United States upon all property and rights to property belonging to said taxpayer. CIRCUIT CO~~
RECORD 1'ERIFII'!T._~
NAME OF TAXPAYER 448392
~i J ~c Frt~nces trrare
RESIDENCE
3957 S US 1
r`t Piercer Fl 33450
UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDED GATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
Ial lbl Id Idl Ia)
101+0 12~-31-7g Ob-il-79 267-X11-1284 1, 3b8.35
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PLACE OF FILING
Clerk of Circuit Court TOTAL S 1,368.35
3t Iucie County Courthouse
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} WITNESS my hand at F't Fierce,F~l _ . on this.
a
the 18th day of June 19 79
SIGNATURE TITLE
Revenue Offi ar
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(NOTE Certrf~tatn of r autlw~raed by law to tab scknowladgrtranta Knot essanoal to tM vslydrty of Notrca of Fadawl Tax Lean G.C.M.
28~ . C.B. 1950- t 5.1
PART 1 - To be retained by recordin office 11 . P!(:
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