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Form •V68 OoWrtrnont d tM TroasUry - intaxnat Rovtanw t3M?irta - 4
~R~ ~~,~,078, Notice of Federal Tax Lien Under Internal Revenue Laws
District Serial Number .~.~J For oOrlona/ !/so btr Racadtny OHlco
Jacksonville, Florida - 49ye~ 1980.A11.23 ~f ~
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 n?ade. but it remains unpaid. Therefore. there is a lien in favor of the United llEto~OVts1~0
States on all property and rights to property belonging to this taxpayer for the
amount of these taxes. and. addfional penalties, interest. and costs that may -
a«xue. - 4g3'T3'7
Name of Taxpayer
F.arriest L. & Hazel Good ?an -
Resider 1, Box 79A -
Fellsmere, Florida 32949
Kind of Tax Tax Period Ended fasts of AseessmerW Identityirtg Number Assessment
I~ [a) le) lo) laD - lol
1040 i z-31-76 0,5-12-80 - 265-52-4005 1, 6Si . z?
1040 iz-31-77 04-28-80 - 1,49g.o1
1040 12-31-78 05-05-80 1r374•SO
~ 1040. 1 z-31=79 d+-o7-80 - 1. z~+3.53
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Place of Filing
Clerk of the Gircuit Court
~ Indian River County Courthouse Tp~l =
Vero Beach, Florida 33450_ - 5.767.31
This notice was. prepared and signed at Fort Pierce, Florida . ~ this.
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~ the 21sE~yof July ,19 80
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Si Title
e
~ .Revenue' Officer PA~~~
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Cartakaq of k:M autrwrrtad Ny Nn ro taka aclknowladpmama kt not aasarnla? ro rM v~tldltp of NoNco a 4
ra: flan . terra, rt~aat, c.e. rta.)
Pmt 1-- To bs kept by recordirq offbe ~ Form 868 (Rev. 9-~8)
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