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Form Department of the Treasury -Internal Revenue Service
(Rev.Septemberl978) ~ Notice of Federal Tax Lien Under Internal Revenue laws -
District Serial Number Fo. ovriotw Use DY Ascordioy tmice
Jacksonville ~~~44 ~ ~ 5 ~ ~ 25
As provided by sections 6321, 6322, and 6323 of the Internal Revenue Code, 5 ~ CO C Y A.
notice is given that taxes (including interest and penalties) have been assessed P~
against the following-named taxpayer. Demand for payment of this liability has 6~tq~T C61Nt7
been made, but it remains unpaid. Therefore. there is a lien in favor of the United e(ZO VERIFIED
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.
Name of Taxpayer 4~14~
Leon & Nanny Holland-
Residence
611 North 24th St. .
Fort Pierce, Fla. 33450
Unpaid Balance
Kind of Tax Tax Period Ended ~ Data of Assessment Identifying Number M A>messment
la) lD) le) - ld) lam)
1040A 12-31-77 02-18-80 419-48-50G0 87.22
1040A 12-31-78 02-18-80 458.82
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Place of Filing
k Clerk of .the Circuit Court
St. Lucie County Courthouse Total =
Fort Pierce, Fla,. 33450
This notice was prepared and signed at Fort Pierce, Fla. . on this,
the 14th day of April .19 ~
Signat i~ i~~ Title
C. J. . Jr. ~ Revenue Offieer
(Hots: Certilicats of otlicer autAoriz law to take acknow/edQmants b not osssntia/ to thtr validity o/ Notice of
Federal Tax Usn O.C.M.?8~1ta, t~561,C.B. 1?5J
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