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F~ ~~g DepaAment ot the Treasury - Internal Hevenue Senice ~~
(Rev.September1978) Notice of Federal Tax Lien Under Internai Revenue Laws
District Serial Number Fo. ovr~o~w uss nr a.ew~ a~~c.
~ 51~5 ~
JACKSONVII.I,E
As provided by sections 63~21, ~ 6322, and 6323 of the Intemal Revenue Code,
notice Is given that taxes (inctuding interest and penalties) have been assessed '
against the following-named taxpayer. Demand for payment of this liabiliy has
been made. but it remains unpaid. Therefore. there is a tien 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. inte~est. and costs that may
accrue.
Name of Taxpayer
VERNON RAINEY. Sr. -
Residence
6i3 s. E. Thornhill
Ft. Pierce, Fl. 33~+5~
Klnd of Tax Tax PeNod Ended Dste of Assa~ment
[a) [b) (c)
1040-17 7~3 t~ ?909 0~+~-z8-80
r~.ce ~r+c FECO~ o
S R~OGER r01TRASA~n
ClER1t GRCUIT C T /~
~l
~•r^c~~ ~~:.:.~~ ,~ °• - -- -
514945
IdentH~rin~ Number
(d)
262-y+-3i78 N
Unpaid Balsnce
of As~essrt~ent
a~
25,197.47
~
This notice was prepared and signed at ~• ~~e. ~•
the 2Uth day pf January_ ~~ g 81.
, on this,
9
f Si ure Title
` Revenue Officer
Ot CNtifiuN o1 ei ~ufhwlr~d Dy Niv f0 t~k~ ~cknowl~dpmMfs b nof ps~ntla/ to UN v~lidpy oI Not~~ o/ ~
~ r,x u«~ o.c . e~~o. »sa~. c.e. ~sa.~ 801K•J~~ PAGE1t~'eJc7
~ Psrt 1- To bs kept by recordlnp offk:e ~ Form 688 (Rev. 8-78) ~
a = ~, _ ~'~ ~_:~.~ ~~=:
~ - -~`"` _~ _ , ~ ~
Mace or rrong
Clerk of Circuit Court ~
St. Lucie County Courthouse Total = 25~197.47
Ft. Pierce, F1. 33450