HomeMy WebLinkAbout1312 Form 668 pepartment of the Treasury - internal Revenue Service
(Rev. September 1978) Notice of Federal Tax Lien Under Internal Revenue Laws
District Serial Number 4935 For Op?iattal Use by Recording Orrice
I~0 AU6 11 AN ~ 28
JACKSONVILLE
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 G.Eli~f(~~ ~ ~
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 REt:ORO YFR1PlF11 _
States on all property and rights to property belonging to this taxpayer for the
amount of these taxes, and additional penalties, interest. and cysts that may 495'7'35
accrue. - I
Name of Taxpayer
ANDREA do MAXINE ROBINSON
Residence
102 LANGSTON IItIYE FORT
Unpaid Bslance
Kind of Tax Tax Period Ended Date of ASSeSSftleflt WAflWyitlQ Number OR Asaef~sment
(a) lb) [c) ld) lam)
1040A i2-31-Tr o6-23-80 264-96-9i54 i,p35,g9
1040A i2-3i-~s o6-30-80 n~ 680.84
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~ Place of Filingg
CLERK vF THS CIRCUIT COURT
sT wcls c~tfNT~r couRTHOUSE Taal t 1, 7i6. 73
FORT pl~cs, FL 33450
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This notice was prepared and signed at ~T FLA . on this,
theme day of JULY ,19 80
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Signature Title
(Hole: C f officer authorized by !aw to fake acknowledgments h not essential fo the validity o1 Notice o/
Pedsn/ 7as Lien O.C.M. 2!)~1g, 19541, C.B. 125.) g ~ p~~~0
Part 1 - To be kept by recording Ffxm 668 (Rsv. a78)
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