HomeMy WebLinkAbout0362 Form 66$ Oopartment o1 the Treasury • Internal Revenue Service
(Rt:v.Sepittmbert97B;~ Notice of Federal Tax Lien Under Internal Revenue Laws
--~-Fw Optional Use Dy Rocord~n Office
District Serial Number ~ , _ 9
Jacksonville
- - --1--- 1940 h'~ Ili lR„~ I I ~ . 2 7
Qs provided by sections 6321, 6322, and 6323 of the Internal Revenue Code,
notice is given that taxes (including interest and penalties) have been assessed ~ r. ~
against the following-named taxpayer. Demand for payment of this liability has " F ,
been made, but it remains unpaid. Therefore, there is a lien in ta~or of the United '
States on all property and rights to property belonging to this taxpayer for the R~_ _ ti.l x.i' ;
amount of these taxes, and additional penalties, interest, and costs that may y`
accrue.
Name of Taxpayer 5U~~3
Donald J. & Janet M. Frey
Res'dence
7~ Lamplighter Park
Daytona Beach, Florida 32019
Unpaid Balance
Kind of Tax Tax Period Ended Date of Assessment Identifying Number of Assessment
~ (a) (h) [c) (d) (v)
I
~ 1040 30 7812 09-03-79, III' 143-12-2435 $1079.29
I
~ I
Place of Filing
Clerk of Circuit Court - Total s 1079.29
~ St Lucfe County
a fort Pierce, Florida 33452
t
r
~ This notice was prepared and signed at Daytona Beach, Florida on this,
~ -
the 31st day of October ,19 80
i= -
Signature ~ ~ Title ~~~~ee~~
f~t?~J
Randall R. {]right Revenue Officer PAGE
(Nuts: Certificate of otl~cor authorized by ?sw to take acknowledgments is not vssvntial fo the validity of Notice W
Fodvral Tax Livn (3.C.rbt. 2tHt~, 19541, C.B. 125.)
Part 1 - To be kept by recording office Form 668 (Rev. X78)
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