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40611
Forth Department of the Treasury - Internal Revenue Service
(Rev September 1978) Notice of Federal Tax Lien Under Internal .Revenue Laws
District Serial Number For ovtrorw use by R.codiny orrice
Jacksonville 1919 $EP 2~ PSI ~ ~
F~~p ~Np RECOIt0E0
As provided by sections 6321. 6322. and 6323 of the Internal Revenue Code. S IlC Cp NNttY.F``A.
notice is given that taxes (including interest and penalties) have been assessed R P~i'fRAS
against the fdlowing-named taxpayer. Demand for payment of this liability has gL~~CU1T C ~
been made. but it remains unpaid. Therefore. there is a lien in favor of the United ~Cpgp vE1t1F~Ee_g•~~~---
States o7t all property and rights to property belonging to this taxpayer for the _
amount of these taxes. and additional penalties. interest. and costs that may
accrue. 4d~11
Name of Taxpayer -
ri. Pierce C:~b Co., ?lic., a cot: ~or~tion
Residence - :
122
~ C3•an~e ~'~vc .
't, :
i crce, Fl. ~~1:5~
Unpaid t3alsnoe
Kind of Tax Tax Period Ended Date of Assessment Identlft?irg Number of At~sment
- lb) leT ldJ
;~r~o 131-7~ ~7-~-?9 59-05; x366 225.?2
- _ -
Place of Filing
Cler., o~ Circuit Cvur`,.
Wit. :azcie Cou~:~y Total i 2?.5.22
,~'t. Pierce, ?i. 33J+5J -
This notico was prepared and signed at i' ;'ierc~, r' . , on this.
the 21st. day of ~.eP'~. .19 79•
Si ature Title _
~,r~ ~:u;, Cf~-icer
ot~ Carriricate f officer .ut by law to take .cknow/edpnr.nts if not .sserrtkd f0 tM validity o1 Notice o/
. 7.r ~ z~t~ , . ~.a. r2t~) ~ X317 ~~i~"T~rttl
Part 1 = Te 6e knot br recording 668 (Rev. 878)