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Form QQ Q Department of the Treasury • Internal Revenw 3ervfce
(Rev.Septemher1978) Notice of Federal Tax Lien Under Internal- Revenue Laws
District Serial Number For oprfonal u:e ny Reeoa~ offke
Jacksonville, Fl. 4~i~ ~ ~ 2~ ~ ~ 15
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 ` YE~~t)
i States on all property and rights to property betonging to this- taxpayer for the
amount of these taxes. and additional penalties. interest, and costs that may
accrue. ,43,4• 4
~ Name of Taxpayer
C. ;1. Croons
i
Residence Rt 4 Box 25
_ ~ _
Fort Pierce, Florida 33452
Unpaid Balanos
KkW of Tax Tax Period Ended Dats of Assesanent Identityirq Number of As~estanent
a~ tn~ tc) tee tee
9~.3 12-31-78- 07-09-79 59-0652763 - 979.13
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~ Place of Filing Clerk of the Ciro
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3t. Lucie County Courthouse ~ Total = 979.13
Fort, Pierce, Florida 33450
This notice was prepared and signed at Fort Pierce, Florida , on this,
'4 the 17th day of ~r~j.l ,19 $0 '
Signature . Title
RSVeriue Officer
f 1>M
(N eC Cantificat• of office/ avt i= try law fo faks aciwowfe0ymanfs is nw assantia/ f0 me w/idify of NoU~ce of
! Tic lien O.C.M. ?tif1Y, 1 , C.B. f?b.j
.Part 1 _
~t'o be _k_
ept br recording ^o~ ~~i ~ Form 668 (Rev. 878)
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