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Form 668
(Rev. September 1978)
District
JACRSONYILLE
Department of the Treasury • Internal Revenue Servke
Notice of Federal Tax Lien Under Internal Revenue Laws
Serial Number Fw Optlontr use Dy Hecadln9 ar-c•
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
accrue.
Name of Taxpayer
SAMMY C & JOHIiNIE R YATES
Residence
2085 NE TRIUf~H PORT ST LUCIE. FL
Kind of Tax
a~
1040
Tsx Period Ended
rb)
12-31-78
N60 OEC -5 ~ g zg.
R!O[MS VFtstFtEp_
~7t7e7jf,I
Date of Assessment ~ tdentifying Number
lc) [dl
05-28-79 ~ 266-02-0244
Unpaid Balance
of Assessment
b1
it~3.35
Place of Filing
CLERK OF THE CIRCUIT COURT
ST LUCIE COUNTY COURTHOUSE Total = 1,063.35
FORT PIERCE, FL 33450
This notice was prepared and signed at FORT PIERCR,~ FI.A , on this,
the 2nd day of H$CEI~ER ,19 80
i Signature Title
~ h REVENUE OFFICER
••. C iNUr• oI oHic•r •uthorir•d M fo t.k• acru~owrdpm•rus b not •sssntral ro tM va1ldlfy of Notlc• o/
F - : t.rn Q.c.w. 2e~t~ tasat, c.e. r .~
Part t,-To be kept by recordirq ~ ~~ ~~ ~~ Form 668 (Rev. 9-78)
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