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pepaAment of the Treasury - Internal Revenue Service
Fwm_ 66a
(Rev.September1978) Notice of Federal Tax Lien Under Internai Revenue Laws
District S@fISI NURIb@f . Fw Optionel Use by Rucwdinq Oflice
Jacksonville, FL ~~'s~~
I~1 FE8 13 AM IQ 06
As provided by sections 6321. 6322. and 6323 of the intemai Revenue Code. '
notice is given that taxes (including interest and penaities) have been assessed S~EO ~,1 ~~~0~ A
against the following-named taxpayer. Demand for payment of this liability has Rp~~R ITRAS
been made, but it remains unpaid. Therefore. there is a lien in favor of the United CIERK CIRCUIT c~UR1
States on all property and rights to property belonging to this taxpayer for the a~~~p ~.E•P~F~F~+ _, _
amount of these taxes. and additional penalties. interest. and costs that may
aocrue. .
Name of Taxpayer
Roland B Nicholson
Residence Rt 4 Box 60
Ft Pierce, FL 33450
Kind of Tax
[a)
1040-30
1040-30
Place of Filing
Tax Perbd Ended Date of Assessment
fb) fc)
7812
7912
Clerk, Circuit Court
St Lucie County
Ft Pierce, FL 33450
This notice was prepared and signed at
05-28-79
OS-19-80
Me~bourne. Florida
5168`74
~
ldenWytn~ Number
[d)
Unpaid 8alanoe
a assessment
' ls)
245-24-4782
u •
Total =
. on this.
the 3~ day of Februanr ,19 81
Signature Title
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cwa« c..r;r r. a onkor .~rnw~.a oy ~.w ~o a~s a~+~o.r~m.~rs K no~~ w ro u-• ~a~axy a Norx• a
Fodorsl Tpc .~ o.c.M. 2e~». »sai, c.B. ~zs.~ ~~~7 PA~'iE~~~
BOll~t
PaK 1- To be kept b~l recordi~ offta,,,e%' Form 668 (Rev. ~78)
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_ 604.13
1~962.51
2,Sb6.64