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Form Oeparttnent of the Treasury - Internal Revenue Service
(Rev. September 1978) Notice of Federal Tax Lien Under Internal Revenue Laws
pishict Serial Number For t)pt%onal use by Raead;ny once
JACKSONYILL}s 4~~M~~ ~ ~ ~N 6r
As provided by sections 6321. 6322. and 6323 of the Internal Revenue Code. p
notice is given that taxes (including interest and penalties} have been assessed
_ against the fdlowing-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 1
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
accrue. 4~~92
Name of Taxpayer
Garfield Seymore
Residence
3111 Ave
Ft. Pierce, Fl. 33450
Unpaid Balance
-Kind of Tax Tax Period Ended Date of A~sment Identifying Number of Assessment
la) fb) [c) (d) [e)
i0t}O ~ 12-31-?8 03-17-80 265-66-8550 1,401.3?
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Place of Fiiing
Clerk of Ciricuit Court ~ Totaf = 1,401.37.
St. Lucie County Courthouse
( Ft. Pierce, Fl. 33450
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This notice was prepared and signed at Ft. Pierce, Fl. , on this,
the 20th day of march ,19 ~ .
Signature Title
Ra Sal er Revenue Officer
E Motar. C N e I oH;car Ized by laver to take acknowledgments b not awent;a/ t0 the valkiify o1 Notke of
Federal Tar .C.M. 2tf~1 1 1, C.B. 125.) (}R
8~ p~ Form 668 (Rev. 8-781
Part 1, - To be kept by recording office: ,