HomeMy WebLinkAbout1881 Form 668 Department of the Treasury -Internal Revenue Service
;Rev. septert~bert97a, Notice of Federal Tax Lien Under Internal Revenue laws
District Serial Number A~~~ Fo. oaional use ny Re~o.di.?v on;~.
JdCKSONVIId.,E, F1iCi.IDA Y
As provided by sections 6321. 6322. and 6323 of the Internal Revenue Code.
notice is given that taxes (including interest and penalties) have been assessed ll~~~~
against the following-named taxpayer. Demand for payment of this liability has 4~vyt11
been made, but it remains unpaid. Therefore, there is a lien in favor of the United
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 ?ILEO a+r: ~ .CEO
accrue.
R~r-. ~S
Name of Taxpayer ~AT::ci.I:?L S'JP.T'L: OOItF:~,.~TIGt: ftECOa R ~ tR
(a ccrporation) np
Residence ~ 11 2 20 P~ ! 7
RT !4, UOX 195, FORT PIERCE, FIArciDa 33452 and/or
P C)3GX IOE7 Dri~Flr.I.?'? NCH F RI
, , IA DA
33441
Klnd of Tax Tax Period Ended Date of Assessment Identifying Number of~iAssessment
~I (a) (D) (W td) [e)
'i 941 03 31-79 10-01 79 59-1679200 $ 2,106.7;
941 Ob--3O 79 10-O1-i5 59 1679200 3,205.93
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Place of Filing CI~".z;, CIRCCIT OOURT,
S:. L'JCIE C0~'IdTY, Total = 5,312.b8
FORT P~itCE, FII.~iILY? 33410
This notice was prepared and signed at FAT Fz~tID~ , on this,
} the- 4~ll day of ~TO~ ,19 79
Signature ~a~i ~ Title
` ~ =:~;~ritn ~ PIG~R
ROBEitT E. WA:. t~.R
(Notes Certdiufe o/ ollicor •urnonzed Dy law to take acknowlsdpminrs is not essential to tAe valid?y of Notice o/
Fsdsral Tar LNn O.C.M. 2819. 19541, C.B. 125-) i1~AM ~ w~~