HomeMy WebLinkAbout1901 Form ~C~ Department of the Treasury -Internal Revenue Service
(Rev.september1978) Notice of Federal Tax Lien Under internal Revenue laws
DIStfICt Serial Number ~~A - A~ For Optional Use by Recording Ollics
Jacksonville Florida ¦~~LZIV~
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
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 TILED AN[ ~~~:OED
j amount of these taxes. and additional penalties, interest, and costs that may iT. tUCi~. ~ • ~ • f~A.
accrue. RO" . _ - ss
CIERr.. ~ rUR~K
•CI!ADn is ~ cc c n !l.
Name of Taxpayer . " ""7u"'~"'
Roy F. Jonesr Jre ~ Z~ 2 24 P~
Residence 7301 Sebastian Road 4'~(~31
~ Fort Piercer Florida 33450
Unpaid Balance
Kind of Tax Tax Period Ended Date of Assessrttettt IdenWying Number M Assessmettt
~ la) (b) lc) td) le)
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f
~ 10%0 12~-31-77 OS-28-79 2b1-6G-6285 603e1,1~ -
1~40 12-31 78 o5-z8-79 z61 66-6285 536.96
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Place of Filing perk of the Circuit court
Ste Lucie County Courthouse Tofa( = lry~p.40
Fort Pierces Florida 33450
This notice was prepared and signed at FOB Pierces Florida , on this.
the lEth day of I~~~~hAr ,19 74
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~ Si ature Title
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Revenue Officer
. Certificate o/ er autAwized by law to fake acknowledgments b not awentia/ to the validity o/ Notice of
!Tax Lien O.C _ M/D, 19541, C.B. 125.) fit~A