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466493
Fwm 668 Department of the Treasury - Internal Revenue Service
tRev.September1978) Notice of Federal Tax Lien Under Internal Revenue Laws
District Serial Number For Opriona) us. by Recordi~y onice
i ~ : ~
Jacksonville~ Fl.
.)LEO RIIR kECGhii u
As provided by sections 6321, 6322, and 6323 of the Internal Revenue Code. sz.lutli:000yir.rl.a.
notice is given that taxes (including interest and penalties) have been assessed ROGER f'GITRtiS
dt~ERK CiRi.RIT C.Gilzs i
against the following-named taxpayer. Demand for payment of this liability has fi~.cc~~~~l'rlr.fn
been made. but it remains unpaid. Therefore. there is a lien in favor of the United
States on all property and rights to properly belonging to this taxpayer for the
amount of these taxes. and additional penalties. interest, and costs that may _466493
accrue.
Name of Taxpayer Samson Rutiylph
Residence 1716 IJ. 17th Street
Fort Pierce, Florida 33450
Unpa~ Balance
Kind of Tax ~ Tax Period Ended Dots of Assessment Identifying Number of Assessment
(aT [b) (c) [d) (e)
1040 12-31 75 Ob-25-79 424-52-1144 1~255.1g
V
Place of Filing
Clerk of the Circuit Court
St. Lucie County Courthouse Thal = 1,255.18
~ Fort Pierce, F'l.orida 33450
This notice was prepared and signed at Faa~t Pierces Florida , on this,
the 14th day of November .t g 79
Signature Title
A ~ i~
C. • mw Revenue Officer Bl~ t~E~~
't (Nuts: Certificate of icer autAwized by laws to take acknowledpmsnb is not ossentla/ to tM validity o/ Noflee o/
9 Federal Tar Lisn O. .261f~ 7oSP1,C.a. f2b.)
Paft t,= To'bekept t)yrecording office Forth 668 (Rev. 9-78) ,