HomeMy WebLinkAbout1560 Form 668 Department of the Treasury -Internal Revenue Service
(Rev.September1978) Notice of Federal Tax Lien Under Internal Revenue Laws
District Serial Number For opticrut use by RaKO.diny Othca
5t~51 ~ J9 t~ ~ 3S
As provided by sections 6321. 6322. and 6323 of the lntemal Revenue Code. ftt,tl~ ~`~t~,
notice is given that taxes (including interest and penalties) have been assessed S
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against the following-named taxpayer. Demand for payment of this liability has CLERK CIRGNT CCU
been made, but it remains unpaid. Therefore. there is a lien in favor of the United o coin vfR~rt~-C- ~ - -
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
accrue. ,~j~l,?$~1
Name of Taxpayer
f
Residence
Unpaid Balance
Kind of Tax Tax Period Ended Oats of Assessment Identifying Number of Assessment
(a) (DJ (c) [d) (e)
io4o iz-31-78 06-25-79 oz6-46-8073 873.37
1040- 12-31-79 05-05-80 2,313.64
Puce of Filing
s CLERK OF TiIE CIRCUIT %OLT;-3T
ST LUCIE COUtiTY COURTHOU~ Total = 3 t 687.01
~f3T PIERCE, FL 33450
.
This Halite was prepared and signed at FORT PIIIiCE~ FLA , on this,
the 8th day of 0CT0 .19 80
Sigtaatur~ Title ~ p~~~
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(N Corti/irate o/ rcer authwirsd oY raw to take acknowledpmanb b not astantia/ to tM ralldiry o/ Notice o/
F a/ Tu Lien Q. 2AI1~ tp54t, C.B. 125.)
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Pali 1 - TO be kept by recordilq Office ~ Form 668 (Rev. 9-78)
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