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Form 668 DeP'trtment of tho Treasury -Internal Revenue Service
(Rev. September 1978) Notice of Federal Tax Lien Under Internal Revenue Laws
DIStfICt Serial Number For Optional Uss by Recosdmg Othce
JACKSONVILLE ~ ~ + I j
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
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 ~~~2
accrue.
Name of Taxpayer
Frank & Sondra Wyatt
Residence _ _
112 Yacht-Club Drive Apt. 8
North Palm Beach, FL 33408
Unpaid Balance
Kind of Tax Tax Period Ended Date of Assessment Identifying Number of Assessment
ls) [b) (c) [d)
I 1040 30 7712 02-04-SO 449-36-6477 !iF 1,882.19
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Place of Filing
w Clerk, Circuit Court _
St. Lucie County Teter = 1,882.19
Ft. ,Pierce, Florida
y This notice was prepared and signed at west Palm Beach, Florida _ , on this,
the~th day of pctc~6pr ,19 aA
Signatur~ Q Title ~~dd
F.A. Roche CG Acting Group Manager~`~+~~ P~ ,
~ (Note: Certificate of officer autAOrized by taw to fakes acknowledymenfs is not esssnliN to fhb validity of Notice o1
Federcl T~s Lien Q.C.M. 2M1P, 1p541, C.B. 125.)
Part 1 To be kept by rtacordiny oKice . Form 668 (Rev. 8-78)
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