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p~ QQQ Deputment of the Treasury - IMernal Revenue SrorviCe ~
(Rev Septembsr1978) Notice of Federal Tax Lien Under Internal Revenue laws
District Sena! Number 1 For ontlomt us. by R~cordiny otnc.
Jacksonville FL S~~J~ ~ SEP 30 AK ~ 32
As provided by sections 6321. 6:122, and 6323 of the Internal Revenue Code. ~TtttE~~~~At~`(iY~LLA.
notice is given that taxes (including interest and penalties) have been assessed RdG~t PDITRAs
against the fdlowing-named taxpayer. Demand for payment of this liability has aERK CIR'CU~t COURT
been made, but it remains unpaid. Therefore. there is a lien in favor of the United RFCORO vf(t(r(ED__~_
States on all property and rights to property belonging to this taxpayer for the
amount of these taxes, and additional penaltiesr interest. and costs that may
accrue.
Name of Taxpayer
S lvester ~ Willie Belle Green
Residence 1110 Ave E
Ft Pierce, FL 33452
- unpaid eslanos
Kind of Tax Tax Prtrbd Ended Date of Assessment identifying Number Of Assee:smartt
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1040-30 7712 02-18-80 261-58-8804 451.13
1040-30 7812. 02-18-80 " 3,101.16
1040-30 7912 06-02-80 " 12,440.40
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Place ofFiting Clerk, Cfrcuit Court
St Lucie County ~ TOta~ = 15 992.69 ,
Ft Pierce, FL 33450 ~
This notice was prepared and signed ai Melbourne, Florida on this,
the 24th days September ~!g 80
Si r Title
Revenue Officer
M CartHluJa ottlcar .uthoi?zae try raw ro tape acknow/adpmanr, la nor assantw to rM valldlry o1 Make a
lax M. 2AI1t1, ,!)50,. C.9. t26J o~~ t~~~~
Part ! - To be kept by eeoorditp Fam 868 (Rev. S-~e)
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