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Fa„~ Department of the Treasury -Internal Revenue Service
tRev.September,978) Notice of Federal Tax Lien Under Internal Revenue laws
District Serial Number Fa Optional Us0 by Recording Office
JACKSONVILLE49'~648
As provided by sections 6321. 6322. and 6323 of the Internal Revenue Code, ~Q ~V~ Zg ~ ~ ~ 7
notice is given that taxes (including interest and penalties) have been assessed
against the following-named taxpayer. Demand for payment of this liability has FIL~~~~gqI~IfIQ COttDEO
been made. but it remains unpaid. Therefore. there is a lien in favor of the United S RQ6t'RCt~OlTRA~~
States on al! property and rights to property belonging to this taxpayer for the CLERK CIRCUtt COUNT
amount of these taxes. and additional penalties. interest. and costs that may REC~RO YERIFIF'0._ ~
accrue.
Name of Taxpayer 4~c A 8
Residence
IERC FL
Unpaid Balance
Kind of Tax Tax Period Ended Dats of Assessment Identifying Number of Assessment
la) rb) fc) [d)
1040 12-31-79 06-16-60 266-82-9313 1,148.42
Place of Filing _
CLERK OF THE CIRCUIT COURT
ST LUCIE CaTNTY COURTHOUSE Total s 1,148.42
FORT PIERCE, FL 33450
This notice was prepared and signed at ART PIERCE. FLA , on this, ~
the_~ day of AUGUST .1 g 80
re Title
1 hx REVENUE OFFICER
ots: CerfiriCate of orrice. authorized by r.w fo rake acknowledgments l: not essanfiar ro the validity o1 Notice o1
Fade„r r.,~ Lien o.c.si.. Za+ro. r~sar. c.e. rss.)
Part 1,- To be kept by recording o~ • P~1444 Form 688 (Rev. 8-78)