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Form 668 Department of the Treasury • Internal Revenw Service
IRev septemberl9Ta, .Notice of Federal Tax Lien Under Internal Revenue Laws
District Serial Number 5~~ Fo. ovrrooa the by aeeordinp onrc.
Jacksonville, FL ~ ~P 22
As provided by sections 6321. 6322. and 6323 of the Internal Revenue Code, St~TRA~~
notice is given that taxes (including interest and penalties) have been assessed t:~T T n
against the fdlowing-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 t~RO ~RtFttO_..-_
States on all property and rights to properly belonging to this taxpayer for the
amount of these taxes. and additional penalties. interest. and costs that may 5~3~
aaxue.
Name of Taxpayer
Davis S~ Sons Concrete Inc a corporation
R~600 Olealder Ave
Ft Pierce, FL 33452
i Unpaid Bafancs
Kind of Tax Tax Period Ended Osts of Asl~rrlent Ideraifyirg Number of Assessment
lU lb) le) l~ /e)
--940-10 7812 OS-26-80 59-1634252 3,329.35
f 941-10 8003 07-21-80 " 1,345.38
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Place of Filing Clerk, Circuit Court
St Lucie County TOE) = 4,674.73
Ft Pierce, FL 33450 .
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This notice was prepared and signed at btalbourne, Fleri da , On this.
the 16th ~y of September f g 8 J
S' ure Title
nd Salyer ~ Revenue Officer
Otet Hlcare 01 aurAOrizad by Nw ro aks acknowreOpmeMa b tenor ia! ro tM valJdhy of Nadce of
e0erai~Tar Wn t3. Ydlrsi: ro3lFf. C.B. 126.) 8~ p~
Part 1- TO be kept by reoordklp_Oifiog ~ Form 668 (Rev. 9-78)
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