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Form 668 - ~ePeRment of the Treasury - Internal Revenue Service
(Rev September1978) Notice of Federal Tax Lien Under Internai Revenue Laws
District $erial Number Fw ovr;oe.r u:s ny Aecwd~n9 a-ice
516bi~ ~I f EB 13 A!~ ~ 06
Jacksonville, FL
As provided by sections 6321, 6322. and 6323 of the intemal Revenue Code, F1lEl~ ~'[ F`coP. 0
sttnci~co~N rY~i A.
notice is given that taxes (including interest and penalties) have been assessed RO(iER POlTRA5
against the following-named taxpayer. Demand for payment of this liability has CLERK CIRCUI? C4 t
been made. but it remains unpaid. Therefore. there is a lien in favor of the United ~~ Eap~ `'+ P"~` {~ -- ~---
States on atl property and rights to property belonging to this taxpayer for the
amount of these taxes. and additional penalties. interest. and cosis that may Sico.y~
~~e vv r
Name of Taxpayer ~
Jinmie Luther Witt
Residence 10209~ S Indian Rfver Dr
Ft Pierce, FL 33450
. Unpsld Balance
Ktnd of Tax Tax PeNad Ended Date of Assessment IdenW~ling Number a Assessment
(a) fb) fc) [d) ' ~~~
1040-30 7912 09-08-80 331-32-1995 569.97
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PlaceofFiling Clerk, Circuit Court
St Lucie County T~~ = 569.97
Ft Pierce, FL •33450
This notice was prepared and signed at Melbourne, Florida , on this,
the 29th dayof Januarv ,~g 81
Signatur ~ ~~ Title ~
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Mot Csrtiriuts ol oNicer aurhorizaf by 1aw to rak~ ~ckno.r~edym b nw ~ss~n I to th~ v~ltdlry a1 ~ o~ ~
( F d 7~x Li~n O.C.M. 26/1O, fo541, C.B. 125.) ~IR ~~p
s SO!?Kec.'i'f0 PdCE~ ~~
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~ Pa~t 1- To be kept~tiy recordl~ olfice'' am 888 (Rev. a78)
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