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t1El'ANt11BIT Oi 11E TaFAtIMt! - lMTilwllt for OPtanal Use BY Recording ONics
IR~EV.62~i~1 NOTICE OF FEDERAL TAX LNUr UNDER INTERNAL REYENdE UUMi .
DISTRICT SERIAL NUMBER
JAC&'~ONVILLE
Pursuant to the provisions of Sections 6321. 6322. and 6323 of the Internal Revenue _
Code. notice is hereby given that there have been assessed under the Internal Rave- 19~ APR 10 PK ~ 3T
nue Isws of the United States against the following-named taxpayer taxes (including
interest and penalties) which after demand for payment thereof remain unpaid. and M~
that by virtue of the above-mentioned statutes the amount of said taxes. together with S R C
penalties. interest. and costs that may accrue in addition thereto, is a lien in favor of ~
the United States upon all property and rights to property belonging to ssid taxpayer.
ftEClll1 ! ERtFlEO
cx~s Bffi~IJAMIN ~ 482.59
R 51DENCE
~2 Ave. Q
Ft. Pierce. FL 33+50 ~ .
UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
Is1 Ib1 ~ lc1 Idl Ie1
1040 12-31-76 3-21-77 266-15-1750 858.91+
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PLACE OF FILING . Clerk of CirCUlt Court
~ St. Lucie County TOTAL S 858.9++
Ft. Pierce. FL 33450 ~ .
g Melbotune~ FL , on this,
WITNESS my hand at
~ 11th day of March - 19 80
SIGNATURE TITLE
(For Crandall) ~ Group Manager
(NOTE: Certyficet~ of officer su ¢ed by Isvir to is n rat Ktentret to the velydAy of Not~oe of Federal Tex LNr? G.C.M.
18~/9.C.8. 1950-t, 125.)
PART 1 - To be retained by recording office 8~~ P~