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Form DepaRment of the Treasury -Internal Revenue Service
(Rev.september1978) Notice of Federal Tax Lien Under Internal Revenue Laws
District Serial Number # F« opcrona) u:• by Itec«a~ orrc•
J ACKSONYILLE vl~rv ! ggp ~pR ~ ~ pp 2 35
ii
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 i vt~~0
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 4~~'7
accrue.
Name of Taxpayer
A T & D Diesel Service, Inc., a corporation
Residence
3233 "D" Oleander Ave..
Ft. Pierce, Fl. 33450
Unpaid Balance
Kind of Tax Tax Period Ended Date of Assessment Identifying Number of Assessment
~ la) lb) (c) ld) le)
941 o3-3i-79 o7-ib-79 59-i~53 z,22b.87
94i ob--3o-79 oi-o'1-80 59-i 8~i653 3. ~O.3i
941 09-30-79 1i-26-79 59-153 3.56i•42
Place of Filing
~ Clerk of Circuit Court Total ; 9,~+68.b0
St. Lucie County Courthouse
Ft. Pierce, F1. 33450
~ This notice was prepared and signed at Ft. Pierce, Fl. . on this,
the 2bth day of march ,19
Signature Title
Ra Sal Revenue Officer
(Nas: C il' I ot/ic•r eufh ed by law to fake acknowladpmenta is not •ssamtia/ to the rafidity of Nottc• o/
F•d•ra/ tax C.M. 2QI10, 1 , C.B. 125.) g f~
Part 1 - To be kept by recording dfiCe~ P~ • Form 668 (Rev. 9-78)