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F~ ~~~ Department of the Treuury =lnternal Revenue Service
(Rev.Septamber1978) Natice of Federal Tax Lien Under Internal Revenue laws
A-r Recading Olfic~
Oistrict ~ Serial Number 5114~ `°' °~"°"" `~'
Jacksonville, FL ~Q ~~ Z3 ~ ~ ~$
As provided by sections 6321. 6322. and 6323 of the Intemal Revenue Code.
notke is given that taxes (incluc~ing interest and penalties) have been assessed ~ ~i1f~
against the fdlowing-named taxpayer. Demand for payment of ihis liability has ~
been made. but it remains unpaid. Therefore, there is a lien in favor of the United Q~.~p~ ~p~ii ~___~
States on all property and rights to properly belonging to this taxpayer for the '
amount of these taxes, and additional penalties. interest. and costs that may
~~ 511466
Name of Taxpayer
Robert ~ Mattie Deshields
R~~~~ 2215 N 43rd Street
Ft Pierce, FL 33450
un~w ea~a~e
Kind of Tax Tsx Period Ended Date of A~ssment IdenWyirp Number W Assassment
t.~ te~ tc~ td~ a~
1040-30 7812 i1-03-80 221-16-4756 1,680.80
1040-30 7912 06-02-80 " 97.45
PlaceofFiling Clerk~ Circuit Court
St Lucie County Courthouse T~' _ '
Ft. Pierce, FL 33450 1 778,25
This notic;e was prepared and signed at Ft• pierce, FL
. on this,
the 12 th day of ~ceznber ~ 9 80
.
Signature ~ T~1e
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Part 1,- To be kept b~-.recadin~ ,. Form 868 (Rev. ~78)
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