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Form D~dnYnt d tM Ttwswy - IetanN Rwa~w SMVIo~ t
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~~~~,~1978j NOiiCB 01 t6Q8~1~~8X men u~ae~ in[~nai ttovenue ~.aws -
. - for o/xwnd ua. R ona. -
Oistrict Sertei[:Number a? . ~
Jacksonville, Fl. _ ~ ~ 19~9~;5'EP ! 0 PN It 35
As pr'ovkied by sections 6321. 6322. and f3:i2~ of the internal Revenue Code. ~ ~ ~
notice ,i~ given that taxes tinduding interest and penalties) have been assessed '
against .the following-named taxPeY~er. Oemand=for paytnertt of this liabililjr has T , €
been made. but it remains unpaid. Therefore, there is a lien in favor of the United VERIFti:
States on aN property and rights to property belonging to this taxpayer for the i
amount of these taxes, and additional penalties. Interest, and costs that may - f -
aocxue. ~ 45790Q
Name of Taxpayer - ~ .
Oberta Lawrence
Residence 2 2 Sterling Court
Fort Fierce, Fl. 33450
. Unpaild Balance
Kind of Ts: , Tsx t~eri0d Ended Dale d A~saarent - IderNityieg Number of Mes~rent .
ca ° ro~ ra rm w -
10l,,i0 12-31-77 01~-10-7$ 254-42~-22b4 ~ 219.00
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P1aoe of Flting Clerk of the Circuit Caurt -
9t• Iucie County Courthouse. - Total i~ 219.00
Fort Pierce, Florida -33450 .
This notice was prepared and signed at Fort Pierce, Florida , on this.
theme day of Auks .ig 79 .
Signatu Tttie
t•'ri Reverrue Offi - -
Mor~C CartHleata o/ olNear authoNzad by law ro aln aeknowladpa?anta k not aaaanflal to tA. •aYd#!? W NoNe., ar
• Farina/ Tax r.lan O. M. 26410.1641, C.a. 126.)
part 1= o be kept bt? reoordlrq office ~ ~ Form 668 (Rev. f~78),
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