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Form 668 D•partma~t of the Treasury - intamat RwM?w Sa~rvice
tRev SaWempar1978) Notice of Federal Tax lien Under Internal Revenue Laws
Distrkt Serif Number Fa ontwa.t taa M ttaeordwq on~c.
Jacksonville r.$ '~i
As provided by sections 8321. 6322, and 6323 of the Internal Revenue Gods. I .
notice is given that taxes (including interest and penalties) have been assessed
against the following-named taxpayer. Demand for paytrtertt of this liability has
been made. but it remains unpaid. Therefore; there is a lien in favor of the United
States on alt 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 49`~~
f~lilliam P. Shingles
Resilience
1110 N. 29th St., Ft. Pierce, F1 33450
Kind of Tax Tax Period Ended Date o! Asee~wnant ldeatlfgitq Number A
moment
a~ ro~ rw cm w
1040-30 7712 06-16-80 266-64-8503 1,984.41
1040-30 7912 ~ 06-02-80 " .217.65
Place of Filing
Clerk of the Circuit Court
St. Lucie County Tots! = 2,201.96
Ft. Pierce, F1, 33450
.
JackBOnville, F1 ~
This notice was prepared and signed at ~ ~ thts.
the lBt ~yM Juiq t9 80 .
Signature T-~
Vincent 8. Dick Bon
? Chief, Processing Section
MoNc c«rmcat• a oMiear autAOrizad ny aw ro tall. acknowladya~anq a nor aasantaY ro tM ralidRp of Natie• a
FaWaf tas Llar? O.GM. 20118 1lib~t, C.B. f?A)
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tlit s~ Part t - To bs kept by rooor~q dtit~ ~ Form 668 (Rev. a78) 3
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