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. Form V6S Department of the Treawry - kitemd Revatw Service
(Rer September,979, Notice of Federal Tax -lien Under Internal Revenue Laws
District Seria3d Number For OpNonN tlse af? Reeowin OH1ce
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Jacksonville, FL '4:~~
As provided by sections 6321. 6322. and 6323 of the Intemai Revenue Code. t~a~~~
notice is given that taxes (including interest and penalties) have been assessed ~~tT
against the following-named taxpayer. Demand for payment of this liability has ~~pA1 Y£R1ftE0
been made. but it remains unpaid. Therefore. there is a lien in favor of the United
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
aaxue. ~ 1
Name of Taxpayer
Verlin K Williams _
Residence 2814 Jefferson Pkwy
Ft Pierce, FL 33452
urea Balwtcs
Kind of Tax Tax Perbd f.nded Owe of Asaestsnterrt Identlryring Number of Assteante`tt
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I 1040-30 7412 02-04-80 330-30-029.5 11,907.72
1040-30 7512 02-04-80 " 3,881.10
1040-30 7612 02-04-80 " 5,781.70
~ 1040-30 7712 03-17-80 " 5,223.62
Place of Filing
Clerk, Circuit Court
St Lucie County TOts~ = 26 794.14
Ft Pierce, FL 33450 ~
This notice was prepared and signed at Melbourne, Florida on this.
the 17th ~y ~ June 1g 80.
Signat Title
~ G A s~ha a Revenue Officer
Mote: CartiNcate o1 oHicar authorizad by pr to take aeknowted0mama b not easaotia/ to tM railOir o1 Notke o/
Fadard Tarr Uan O.C.M. ~f34r0, 1054/, C.B. 125.)
Bt3~!(cJJ~ P'~(iE ~ Part 1 - To bs kept by reoordMtg offbe 7 Form a68 (Rev. a78)
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