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Fof1n 668 Department of the Treasury -Internal Revenue Service ,
(Rev.Septembert978) Notice of Federal Tax Lien Under Internal Revenue Laws
District Serial Number ~t,~ Fo. Oatlarfal use by Recadinp onlc•
JACKSOhlILI,E 190 tr4'J -4 P~1 12. 14
As provided by sections 6321, 6322, and 6323 of the Internal .Revenue Code. s. l i ~ . r. ~ ~ x.
notice is given that taxes (including interest and penalties) have been as.Sessed c:: ~=)°..~:~:.a
against the following-named taxpayer. Demand for payment of this liability has cz::=~ p
been made, but it remains unpaid. Therefore. there is a iien in savor of the United r~=u~ ~ ~ ~ -~r =
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 S(~~4?~r
accrue.
Name of Taxpayer
'JFRNAI, ~ 70ROTHY BOWE
Residence
1709 Ave '7" -
Ft. Pierce, Fl. 33450
j Unpaid Balance
Ktnd of Tax Tax Period Ended Gate of Assesslne~t tdantifying Number of Assessment
(s) [b) lc) l0) lam)
1040 12-31-?4 06-30-80 265-4z-z586 2,051.82
1040 12-31-75 06-23-$0 265-42-2586 i,28o.i7
1040. 12-31-?6 06-23-80 265-42-25$6 1,755.42
1040 12-31-?? 06-02-80 26542-2586 1,160.02
10~ 12=31-?8 C6-02-~~ 26` ,2-25°6 3,236.0°
1040 12-31-?9 08-25-$0 265-42-2586 1,?16.48
Place of Filing
Clerk of Circuit Court -
~ St. Lucie County Courthouse Tots! = 11,199.99
~ Ft. Pierce, F'1. 33450
This notice was prepared and signed at ~ • Piercer ~ • , on,this,
the 20th day of October ,1 g 80.
Si ure Title
Revenue Officer -
• CN(iNcat• ollaN authorii•d by Nw fo fak• scknowladpm•n/s b not assentlal fo the vaUdMr o/ Norfcl W
! I Tax Uar M. ?0~ f o, t pb41, C.B. 125.)
Part 1- To be kept by rOCOfdInQ voffkeW11 - P~ ~ F~xm 668 (Rev. a78)
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