HomeMy WebLinkAbout0612 463911 -
Form 668 Department of the Treasury -Internal Revenue Service
(Rev. September 19781 Notice of Federal Tax Lien Under Internal Revenue Laws
District Serial Number ForpOptionalTUrs~ecDy R,eucordl~iny Ofgfice
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As provided by sections 6321, 6322, and 6323 of the Internal Revenue Code, FilEO n~ C' PkC01tJkU
gT.LL'C!_ COUYTY.FLA.
notice is given that taxes (including interest and penalties) have been assessed ROGER polTRAs
against the following-named taxpayer. Demand for payment of this Liability has CLERK CIRCUI~ Ot~'ty -
been made, but it remains unpaid. Therefore, there is a lien in favor of the United RECrIo ~'_F F~~!'- - -
States on all property and rights to property belonging to this taxpayer for the
amount of these taxes. and additional penalties, interest, and costs that may 44;3911
accrue.
Name of Taxpayer
Residence
Ill: '.r _ = -c:.
Unpaid t3alance
Kind of Tax Tax Period Ended Gate of Assessment Identifying Number of Assessment
Iw) !A1 rN fd) !0) '
~t . %i
i
i
4
Place of Filing
~'i.. _ ~C'.1?"~i.;j Total s 2,~>~:•~1
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This notice was prepared and signed at _ ="-^c•~ ~ _ , on this,
R
i~
Fi
the ` ~ ~ ::day of ^1 _r ,19
Signature Title
t -
Cerrificare of er authonzed by law fo fake acknowledgments pis{l~ tia! to RY of Notice of
F e?al Tar Lien . 2t34fg, 1950-1, C.B. 125.)
ao~c r~
-Part 1 - To tie kept btr recordirtQ oftkx ~ _ _ _ Form 668 {Rev. 9-78? -
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