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Form 668 Oepattment of the Treasury -internal Revenue Service
iRev.september,97e) Notice of Federal Tax Lien Under Internal Revenue laws
District Serial Number S~~S~ For oafonar u:• br R•eodinp onke
JACKSONVILLE
As provided by sections 6321. 6322. and 6323 of the Internal Revenue Code, i~~'~
notice is given that taxes (including interest and penalties) have been assessed P„ ?2- ~
against the following-named taxpayer. Demand for payment of this liability has f : t ~ ~r . _ , , .
been made. but_it remains unpaid. Therefore. there is a lien in favor of the United s ~ ` ` ' ~ " " ~ i ; a
F:
States on al! property and rights to property belonging to this taxpayer for the ~t,-:~t=~,~~.;".'::~
amount of these taxes, and additional penalties. interest, and costs that may F~:cal; Y{ o,f _ ~F
acxrue.
Name of Taxpayer 5`)s~(7a)~
DOUGLAS MULL
Residence
4401 N FEDERAL HWY
Unpaid Bslattcs
Kind of Tsx Tax Period Ended bats of A'saessment IdsMifyirq Number of Asssssmont
~ fa) l0) lc) (d) l~)
1040 12-31-79 06-02-80 390-!16-3850 2, 212.50
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Place of Filing
CLERK OF THE CIRCUIT COURT _
S`~ LUCIE COUII~Y COURTHO[JSE Total = 2 ~ ~ 2 • ~
FORT PIBACEr~ 33450
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~ FORT PIERCE FLA
This notice was prepared and signed at r , on this,
the 31$tday of .19 ~
sig rule
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C•rtiriCat• onto autnorrr.d a raw ro ak• aelrnowldpmerrb b not •ss•ntld ro rM rtrdditi a1 NatJce o/
F 7u U•n M. 2br11i r>iSa1. C.a. r26.)
Form d6$ (Rev. 9781
Part 1- To be kept b!I recording otfioe a
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