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Form 668
( Rev. September /978)
- DepaNment ot the Treasury - internal Revenue Service
Notice of Federal Tax Lien Under Internal Revenue Laws
~IStfICt Serial Number 5114'70 Fw OptioM/ Use by Recoiding Oflice
Phoenix 8601-00-25526 1,980 DEC 23 ~I f~ 09
As provided by sections 6321. 6322, and 6323 of the Intemal Revenue Code, S~E .'~ ~
notice is given that tanes (inciuding interest and penalties) have been assessed ~
against the following-named ta~cpayer. Demand for payment of this liability has CLENK CIREUIT ~
been made, but it remains unpaid. Therefore, there is a lien in favor of the United ~£a~ ~~RIFIL~. ._
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 5114'70
accrue.
Name of Taxpayer
R. EDWARD KEARNS & MAHIN N: KEARNS
aka Mahin N. Neyestani
Residence
5129 N. 15th Street, #407
Phoenix, AZ 85014 ~
IU~td of Tax Tax Period Encled Qete of AsssssmeM
(a1 [b) [W
1040 12-31-79 05-26-80
IdenW~rln~ Number
[fi
362-42-2167
Place of Filing
St. Lucie County Clerk of Circuit Court
Ft. Pierce, Florida
This notice was prepared and signed at
Phoenix. Arizona
Unpaid Bslance
vf Assessment
[u
3,404.87
Tata1 ; 3,404.87
, on this,
~ the 3rd dayof December ,19 ~(1
' Signature Tn1e
Special Procedures Advisor OB
Mar. C~rtN o/ of11cM authorizod Dy-Taw fo t~ke acknowlWymor-fs 1s ~of pasntla/ to tM validity O/ Nofic~ o/
F~al Tax ~ n O.C.AI. 2A~1~ 1950-1, C.B. f25.) l~e~ P~~
PaM 1- To be kept b~- recordin~ oHbi~~ ~~~Form 668 fRev. 9~78)
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