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F~ 668
(R~v Septombsr 1078)
Oistrict
JACK3f~iVILI~
DepaAment of tM Treasury - Intem~l Rw~nus S~vlc~
Notice of Federal Tax Lien Under internal_ Revenue Laws.
Serial Number r~~O Foi OpNOMI Uq OY R~eorWnp OfHe~
S 1~ JAN -6 PM 3 3~
As provlded by sections 6321. 6322. and 8323 of the Intemai Rsvenue Code. -~t`.E ~A~0~~N~~
~otk:e is given that taxes (including interest and penalties) have been assessesi Rb~ ~ T~~st
against the fdlowing-named ~ taxpayer. Demand for payment of .this liabiliry has ~~ ~s ~.
been macfe, but it ~emains unpaid. Therefore. there is a lien in favor of the United pE~tpYERIFiEO___ ~
States on all property and rights to property belonging to this taxpayer for the
amount of, these taxes. and additional penaities. interest. and c~sts that rr~ay
aocrue.
Name of Ta~cpayer _
Le~roy Bella~y
Residence
2114 N. 43~cd St.
Ft. Piercer Fl. ~F 0
Kind of Tax Tan PeHod Ended Dste W Ana~rnent Idsntiy-in~ Number
fa) fb1 [e) (dJ
io4o 12-31-79 06-30-78 266-~w-13os
512;45.0
"` Unpdd ~ta~ce
o? A~e~nent
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5,~+5.~+
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This notioe was prepared and signed at ~• ~~Ce, Fl.
the Sth dayof January ,19 81.
. on this.
Sig Title
~
~ Revenue Office~ ~~~ P~
cNtHlur. W auMan~d Dy Nw~ ro rak• ~cknowl~dpm~ms p not ~sa~ntld fo tM ratid~p a Matb~ a
F Tu Ll~n O.C. . t0 t~t, C.B. 1?5.) ~
` .
Part 1- TO be keP~ b'1- rscotdln0 offbs; w-m 8d8 (Rev. 9-78)
J .~ ~
~=-:i~
Place of Filina
Clerk of Circuit Cm.irt
St. Lucie County Courthouse Totel = S~~'~+S•~+
F`t. Pie~ce, F7.. 33~+50