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Form 66$ pepartment of tho Treasury -Internal Revenue Service
(Rev.September,978) Notice of Federal Tax Lien Under Internal Revenue Laws
District Serial Number For optional uss Dy Recordir~q ollke
Jacksonville, Florida ~ t; t!;!; ; ~ : 2
_ ~ ,
As provided by sections 6321. 6322, and 6323 of the Internal Revenue Code,
notice is given that taxes {including interest and penalties) have been assessed ' ~ '
against the following-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 - ~ ~ ~ 1 ~ -
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. ~U~a~O
Name of Taxpayer
Gerald P. Ktiltainski
Residence 7201 Kenwood Drive
Fort Pierce, Florida 33450
Unpaid Balance
Kind of Tax Tax Period Ended Date of Assessment Identifying Number of Assessment
la) (D) le) ld) (s)
855.65
l~ 100q~ Penalty 12-31-77 Oi+~-28-80 330-30-9977N
I
Place of Filing
Clerk of the Circuit Court
St. Lucie County Courthouse Total = 855.65
Fort Pierce, Florida 33450
This notice was prepared and signed at Fort Pierce, Florida , on this,
the_ 13th day of November ,19 80 .
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Sign Title
mw Revenue Officer {,k~~ p~~
i
(r't Certihcal of ollicer authorized Dv law ro lake acknowledymsnls is not assanfial to the wlidiry o1 Ndlce w
~ ral Tape Lie .C.M. 2Nlla, I~Sf}f, C.B. /25J ,
Pert 1 - To be kept by recording office ' Form 668 iRev. 9-78)