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Forp~ @~~ DepaRment of the Trefawry = Internal Rwenus Ser\rlce
cRe+~sevtem~.r,9T8, Notice of Federal-:Tax Lien Under Internal Revenue Laws
District - Serial Number Fo. oplwn•? u,• M A•eordfnp onk•
Jacksonville -
As provided by sections 6321. 6322. and 8323 of the Internal Revenue Code, -
notice is given that. taxes (including interest and penalties) have been assessed
against the tdivwing-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
States on aii property and rights to property belonging to this taxpayer for the
amount of these taxes, and additional penalties, interest, and costs that may L~ 41.2
accrue.
Name of Taxpayer
J s K. Johnson
Residence
1511 North k3rd St. -
Fort Fierce Fla. 33450
Unpald Bafsnos
KhW of Tsx Tax Period (Ended Date of Assesanent Werlti~rNq Number of Assesanern
W (b) (e)
101~fJA 1z-31-7g 05--2&-79 2b4-86-171? 210.00
w ry;
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- X19 AtfG ~0 ~M ~ 4Z
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I~tIRT
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Place of Ring
Clerk
~ a^t. Iucie County Courthouse Totsi = 210.00 -
Ft• Fiercer Isla. ,3450 ,
-
` Thia notice was prepared and signed at _ Fort Pierce , on this.
i
theme dayof ~~-~~t ,,9 ~9 ~~3~.4 P~2
Sig Title ) -
. , ~
(Mote: C•itHlcate a affie•r aut?eorfz•d by raw to hk• aeluww?•a~pni•nts a cot sss•ntlN ro tM validlry o1 Nalc. of
i•dal Tvr Ltn O.C.AI.2b110, tiab4l, C.B. 12b.)
Psrt 1
'=:,To`be.kept~Ml~r~ecoMkq
oHk!~ Fam 688 (Rev. 978)
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