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Perm 668
(REV, NOV. 19611
- O. 'R:'
80: "
u. s. nEASURY DEPARTMENT. INHitNAl .EVf~~ .,5E~~... '. :.- .': , .
NOTICE OF FEDElAL TAX LIEN UNDER INTERNAL:.itY..ENUl.LA~'
" ]Sl:RIAL NUMBER
Jt.ckeonville, l'la... --
Pursuant to the pfovisions of Sections 6321, 6322, and 6323 of the Internal Revenue Code of 1954,
notice is hereby given that there have been assessed under the Internal Revenue laws of the United State,
against the following.named taxpayer, taxes lIncluding interest and penalties) which after demand for
payment the~eof remain unpaid, and that by virtue of the above-mentioned statutes the amount of said
taxes, t-:>gether with penalties, interest, and costs that may accrue in addition thereto, is a lien in favor
of the United States u~n all property and rights to property belonging to said taxpayer, to wit:
IllifRICT
NA.ME OF TAXPAYEIt
__CbMhe L. ~..th
ItHiIDENCE OR PLACE Of BUSINESS
150 Ea.t~ Terrace Ft P~erce
TYPE OF TAX AND PERIOD
(01
ASSESSMENT DATE
Ibl
REFERENCE NO.
(e)
AMOUNT OF
ASSESSMENT
(dl
Add1. 1959 1.T.
2-16-62
670.59
62-0-8525
PLACE Ot FILING
Clerk, Circuit Court
st. Luoie County
Ft. Pierce. F1&.
TO'" I' _ 670.59
WITNESS my hond at
West Palm Beach. Fla.
____, on this,
the
8th day of
I 19--6:L
April
P""'::~~:~' ::::WU'5r:u e! A~~~1 ":1l0et10n~8.r--
IN")rE, (e",f,c"'e of offICer authorized by law to tuko acknowledgment. i. rn:.! "ssenlial to Ihe vul,d'ly of Nol<ce of fej"rul Tu-< Lien (",L.I.\, :<t.~ 19, CB.
19SQ.51,125)
P.6RT 1 - To be retained by recordin'J office
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