HomeMy WebLinkAbout1359~
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F~ 668
( Rev. September 1978)
District
JACLSONVILLB
Oeputment of the Treasury - IntKt~al Ravenue Service ~~
Notice of Federal Tax lien Under Internat Revenue Laws
Serial Number Fo~ OPUOnaI Uss Dy R~cadirq ONlco
51494~
As provided by sections 6321. 6322. and 6323 of the intemal Revenue Code.
notice is given that taxes (including interest and pe~alties) have been a~sed
against the followi~g-named taxpayer. Demand for payinent of this liability has
been made. but it remains unpaid. Therefore. thene is a lien in favor of the United
States on all p~operty and rights to property belonging to this taxpayer for the
amount of these taxes. and additional penalties. interest. and costs that may
~,e.
Name of Taxpayer -
HIT.I.IB LSB CI.ARK
Residence -
428 N 22nd S~iBBT FORT PI~CB~, FL 33450
Kind of Tsx Taz Period Ended D~te o/ Ass~nent
(a) (D) fc)
1040A 12-31-77 i2-15-80
1040A 12-31-78 12-22-80
1040A 12-31-79 . 12-22-80
Place of Filing
CLBRR OF T!~ CIF.CUIT
ST LUCIS CO~l1Y COi~TH0US8
FORT PIBEGCE, FL 33450
This notice was prepared and signed at FORT PISRCE, FL1
Total =
1,884.23
. on mis,
the 2~ day of JANt1ARY .19 ~ ~
Signature ' Title
~1 ~ ~~~~1~11/1 J . hv REVBN[~ OFFICBR
~
Ma~ ce.r~~c.r. a ark.. .wnwr:.o by aw ro ak• ac~tnow~~dp~n«~n a na ~ss.nrr.r co rn~ ~~iw~ry- a Noejc~ a
f.d..., Tu ~ o.~.~,. z~.,~. ,~~,. ~.8. ,zb.~ ~~347 P~13~~
~ Part 1- To be kept by ~ecordlrq office,~ F«m 688 (Rev. 9-78)
~~ - ~
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19~ JAN 27 JW ~ 45
i1LEl' RNC F~ coR[k a
s R~O~GE~R Pp01T~RAS~~
CLERIS CiRCtNT Ctti;; ~J
=F;^r~ry~1 ~~rr:. ~_' ~ -- -
514942
Unpaid Bs~noa
WsMifyin~ Number of Assess~nent
fd) !~)
257-26-8100 537.72
~~ ~~ ~i 711.37 .
" " " 635.14
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