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Form 6~ OePaKment or tM TrOawry - InterrW RwMw Sonic.
~Re,r.s.pt~„eer,9,a, Notice of Federal Tax_ 1~en Under Internal Revenue Laws
District Serial Number Fo. a>x~ us. bi? a.caa~w ome.
Jacksornrille, Florida ~4'rT9~'S 1930 ~IA~ -4 i~ 08 r
As Provided by sections 6321. 6322. and 8323 of the Internal Revenue Code. F! EO I?MO kECt?ROEO
notice is given that taxes (including interest and penalties) have been assessed Si~
G~R
P~OITRAS~
against the fdlowing-named taxpayer. Demand for payment of this liability has +G.ERK CIRCUIT
been made. but it remains unpaid. Therefore. there is a lien in favor Of the United ,\~ER1Fi[o~-~~
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
aaxue. -
Name of Taxpayer 4 ~ ~ IJ~
denoG~e"orge_ D. Hvozsky
Rest-- -~65 Fernand3.a Street *1 -
Fort Pierce, Florida 33450
Unpaid Balaece
KNfd of Tax Tax Period Ended Oats of Assesarrsnt Identltyhg Number - Of Asaessmsnt
lU (b) (o) ldJ ?
1040 12-3i-76 09-25-78 iS6-18-7553 .109. y+
1040 12-31-?? 12-11-78 891.85
Place of Filing Clerk of the Circuit Court
St. Lucie County Courthouse Tp~l = 1,000.39
Fort Pierce, Florida 33450.
s
This notice was prepared and signed at Fort Pierce. Florida ~ r
- . on this, f
the 19th day ofFebntarv ,19 80 ,
Signature -Title
ax .Revenue Officer
(No1.c C~rtfrcto 01 .atr?orizd bf r:« to r.lta .eArnowldpn?.nn !s nor /s.ntlo/ to rM v~UQXrr a/ Notrc. or
FoWra! Tu Uon O.C.M. 2 1>i50.1, C.a. 125.)
Part 1- TO bs kept by ra00rdirlg OtfiCO;' Form 888 (Rt3v. 878)