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Department of the Treasury-Internal Revenue Service
Fam ~$-F Notice of Federal Tax Lien Under Internal Revenue Laws
IR~r. October 19781
Oistrict Serial Number
240110 B-207 P-1103
Jacksonville, Florida
As provided by sections 6321, 6322, and 6323 of the Internal Revenue Code, notice
is given that taxes (including interest ~d peralties) have been a~ssed against the fol-
lowing-named taxpayer. ~emand for payment of this liability has been made, but it
remains unpaid. Theretore, 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
Simeon ~ Thalia Adderly
P:asi:, :~lce S~L~
2410 Coral Aveaue
Fort Pierce, Florida 33450 .
1
4'
Fo~ Optiona/ Use By Recording ONice
514941
1981 JAN 27 IW ~ 42
FIlEO Al-C R`~O~St~'fl
s R ~ R ~TRASA
Q~ IIK CIRCUtT COURT
RFCORl1\n'RtF!f~' __ ._ __.~ .
lCir~d ot Tax MFT Tax Period Ended Date of Assessmsnt Identifying Number
(aJ (b1 (c1 fd1 (el
Z~J40 ' 30 12/31/71 5/15/72 261 14 4190
Place of Fil~ng
Clerk, Circuit Court
St. Lucie County
Ft. Pierce, Florida
Total
Notice of Federal Tax Lien Refiling
IRS Senal Number
Clerk, Circuit Court
Not~ce F~led W~th St. I.ucie County-Ft. Yierce, Fl.
Taxpayer's Address (/ different than own abovel
S~gnature Q~~~ ~"~'~`'~
Van B. O+Neal
T~~~s notice v,ias prepared and siyned at ~1e8t P81m BeBCh, FloridA
tt~ ~d daY of OCtober ,19 72
s~gnature ~e/ Th~mBS C. Graves
D~ ~
Unpaid Balance ~
_ oi Assessment '
rf~ ~
i
.
1,785.25
. ~
~ S 1,785.25
.
Recorder's Identification Number
Date
T~tle ~ie£, Special Procedurea St.
1/14/81 ,
T~~~ Group 3upervisor
,on th~s.
( N OtA: Certi/ic~te o1 o/licerautho~ized by law to take acknow/edginents is not euentia/ to the validity of Notice ol Fede~al Tax L ien
G.C.M. 26419, 195a1, C.B. 125.1 b
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