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Form 668 DePaNment of the Treasury - Internal Revenue Service ,
(Rev.September1978) Notice of Federal Tax Lien Under Internal Revenue Laws
DistriCt Serial Number Fq Optiona/ Uss by AocordmQ Offics
Jacksonville~ FL 5~68~3 ~I fE8 13 AM ~ 06
As provided by sections 6321. 6322. and 6323 of the Intemal Revenue Code, F~~E~ R~G F= CORp~0
ST,LUC E COUtiTY.~t A.
notice is given that taxes (inctuding interest and penalties) have been assessed ROG~R POITRAS
against the following-named taxpayer. Demand for payment of this liabiliiy has CIERK CIRCUtt coUrtt
been made, bui it remains unpaid. Therefore. there is a lien in favor of the United ~'' r'~'' ~•f `'`'` `' --- -
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
Residenoe
Kind of Tax
[a)
1040-30
1040-30
1040-30
Place of Filing
Freddie Washinf~ton '
529A N lOth St
Ft Pierce~ FL 33450
Tax Period Ended Date ot Assessment
(b) (e1
7712
7812
7912
12-01-80
12-29-80
12-08-80
Clerk, Circuit Court
St Lucie County
Ft Pierce, FL 33450
This notice was prepared and signed at
,
,. .
Melbourne, Florida
. on this,
t~ 3rd ~y af February 19 81 ~I
.
Signature . Title
E ~'~ ~~~ r ~ r .~~/
I ot~: CartNiuta ol ~cer aufhorrzed Dy /aw fo faks acknow/edpmonfs is nof tial to fM vafldify W Notie~ ol -
F~der~l Tex Llon O.C. . 28119. 195o-1. C.B. f25.) r~ ~v~~
~ B~~i pdt~
~ PaK 1- To be kept b~r recordiny oNks`, Form 668 (Rev. a78)
~~ ~
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Ide~tif~-Iny Number
[d)
266-52-9624
~~
u
J~16~' ~a;
Unpaid Balance
' of Assassment
t.~
1,166.12
1,121.12
1,139.65
,
Totel ; 3, 426. 89