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Form QQQ Departmatt W tM Trwsury - Int.rnal Rw.nw 8.rvic.
~Rgy,~~p~,BTg, Notice of Federal Tax lien Under Internal Revenue Laws
District Serial Number Fa orNlonM l/s. M Aaco~dinp onto.
4~T39 198 JUI.23 IW ~ 58
Jacksonville -
As provided by sections 6321, 8322. and 6323 of the Internal Revenue Cale. A,
notice is given that taxes (including interest and penalties) have been assessed t/
against the following-named taxpayer. ~ Demand for payment of this liability has 1
been made, but it remains unpaid. Therefore, these 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
aC~rue. ~ 493'?'39
Name of Taxpayer -
Mcaci-is-&lge Nasomy, Ino. -
ResidenCe
606 Yillo~rs Ave. ~ •
Port St. Laois, Fla. 33452 -
Ur~sid ealartce
Kind of Tax Tax Period Ended Date of Assessment Idetriityirg Number of As:essatent
N) lb) le) ld) (a)
j 94i o9-3~-79 o3-3i-~ 99-i875333 i?19.25
' 94i i2-3i-?9 o3-3i-80 - 6T9.33
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Place of Filing
- Clerk of the Circuit Court Total =2398.58.
St. Lucie County Courthouse -
Fort Piierce, Fla. 331+50
This notice was prepared and signed at Fort Pierce, Fla. - , on this,
the 18th day ~ July g 80
Signature Title
b~~ ~
C. J , Jr. Revenue Of~iosr
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Mabe CartHtur. w oH1cN authorrzad M raw ro tall. acknowgdpenanb ~ rwt aaa.ntid ro tM vapdJty a/ Nonc. a1
F.dua/ At Uan O.C.M. 20~rq, rab0•r, C.B. 12bJ -
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Part 1- To bs kept by retmrding oftios ~ Form 668 (Rev. 9-78)
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