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'-661
(REV, NOV. "ill)
U. S. TREA$UItV DEPARTMENT. INTltNA.l IfYfHUt aflV.Cf
NonCE OF FEOWAL TAX LIEN UNDER INTElNAL ~EV
A. -
.IiTRICT
JAC!c'sQ.'IIVlu..J:, J'LORIDA __ _
Pursuant to the provisions of Sections 6321, 6322, and 6323 of the Internal Revenue Code of 1954,
notice :s hereby given that there have been assessed Ul"lder the Internal Revenue laws of the United Statei
against th9 following-named taxpayer, taxes (including interest and penalties) which after demand for
payment thereof remain unpaid, and that by virtue of the aoove-mentioned stCltutes the amount of said
toxes, together with penalties, interest, and costs that may accrue in addition thereto, 1s a lien Ir.. favof
of the United States upan all property and rights to property belonging to said taxpayer, to wih
Nl'ME Of TAXPAYEIt
W~_l1i&IA E. Miller .L~lll.. J:. Miller Tnoldns
1tE6IDfNCE OR PlACE Of BUSINESS
120 Rooel Fort Piorce Florida
TYl'f Of TAX AND PERIOD AS5E$SMENT DATE ItE'ERENCE NO, AMOUNT OF
(a) (bl (el A~Ess.Y.[NT
(oJ
940 Futa 12-61 1-18-6' 59-0978511 I 61.84
941 Withholding 6-62 1-18-6' 59-0978511 291.12
941 Wi thholdin.. 3-62 1-18-6' '9-09'78511 296.38
PLACE Of FILING
Clerk, Cirouit Court
St. Luoie Count1
Fort Pieroe. Florida
TOT A.l $ 649.}4
WITNESS my hand at
We.t Pal. Beach, Florida , on this,
the
28th
, 19~
day of
March
DISTRICT DIRECTOR Of INTERNAL REVENUE
Mana r
(NOTE, Certificate of oflker authorized by low 10 lok. o~knowl gmen'. I. roO: ."en'iol 10 'he validity of Notice of Federal To)( lien G.C,M. 26.19, C,6.
1950.51, 125,1
PAaT 1 - To be retained by recording oftlte
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