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F~ pepartmsot W ths Tressury - Internal Rwenus Servlce
(Rev.September1978) Notice of Federai Tax Lien Under Internal Revenue Laws ;
District Serial Number For OpNonal us~ Oy Axwdinp Olfics
~ I9T9 Jl~i 29 A~! 9~ 02
Jacksonville ~
As provided by sections 6321. 6322. and 6323 of the intemal Revenue Code. .f~ ~ I~~~T~Y.
A.
notice is given th8t taxes (inciuding intere~t snd penaities) have been assessed ~ i~ER POITRAS
against the fdlowing-named ta~cpaYei~. . Demand for PaYment of this liability has q,~RK C4~~P,~
been rtiade. but it remains unpaid. Therefore. there is a lien in favor of the United /tf~+Ql~ YERIF~F.Q~.`
States on ali property and riflhts to property belonging to this ta~cpayer for the
anwunt of these taxes. and additional penalties. interest, and oosts that may
4~69~i8~'
Name of Taxpayer ~
George C ~ Ruth Dix
Residence
~ Rt 2 Box 49A
Lake City~ Fl 32055
unpsia esl~ce
! Kind of Tax Ta~c Period Ended Dsts d As~ment Identlfyinq Number of Assessn~er~t
~ a~ to~ to~ re~
1040 12-31-78 6-11-79 266-60-8478 82.95 -
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Place of Filing
~ Clerk of the Circuit Court T~~ _
St. Lucie County 82•95
Ft. Pierce, F1
~ Jacksonville, FZ , on this, ~
^ This notice was prepared and signed et
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t~ 21st ~ of June 19 79 ,
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Si~nature Title
Revenue Officer
~ (Not~c C~rfNiut o/ t a~ufAwhsd Nw to tak~ acknmHW{~m~nfs b not Ns~nf1U to tM ralidky 0~ Nofk~ of ~
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