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Form pepartr»ertt of the Treasury -internal Revenue Service
(Rev.Septembert9T8; Notice of Federal Tax Lien Under Internal Revenue Laws
District Serial Number For Optional Use by Recwdirq Qftics
Jacksonville
As provided by sections 6321. 6322, and 6323 of the Intemai Revenue Code,
notice is given that taxes (including interest and penalties) have been assessed
against the following-named taxpayer. Demand for payment of this liability has
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 lE0 ~rtt. ~:OEO
~.lUCtf. r'ty FLA.
accrue. .°•i'_ 15
Name of Taxpayer RECQW' = ~ , r ;
Koley, Inc., a corporation ~ 21 2 23 P~
Prescri tion Center ~,,~r~r~
Residence 41~a~/Fi
1223 Delaxare Ave.
Ft. Pierce Fl.
Unpaid Balance
f(~d M Tax Tax Period Ended Gate of Assessment fdentiflling Number of As~ssrrtertt
al rep rc) rd~ a~
941 09-30-78 07-16-79 59-1430306 1x700.39
94i i z-31-78 a7-16-79 z, i 34, 87
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Place of Filing
Clerk of Circuit Court
St. Lucie County Courthouse Tots) = 3,835.26
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Ft. Pierce, Fl. 33450
This notice was prepared and signed at Ft. Pierce, Fl. _ , on this,
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the 12th ~y of December .f g 79.
Signature Title
e
Ray Sa1ye Revenue Officer ~
tNot~ C / s oHicM avtA try law to taksj acknowladpments b not estantia/ fo th• validity OI Notice Of
Fa~daral Tar Q . Af. 26I t t SO~ t, .9. f 25.) - - -