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form 66.
(REV, NOV. 1';>611
O,R~
RL"K
u, S, TREASURY DEPA~TMENT. INTHNM IltVtNO;: ~f '
NOTICE OF FEDERAL TAX LIEN UNDER INTEiNAl.URlv~iYt.AWs
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60 IlM513
.. J SERIAL NUMBER
Jacksonville. norid& -
Pursuant to the provisions of Sections 6321, 6322, and 6323 of the Internol Revenue Code of 1954,
notice is hereby given that there have been assessed under the Internal Revenue laws of the United Sta:ei
against the following-named taxpayer, taxes !including interest and penaltiest which after demand for
payment theroof remain l'npaid, and that by virtue of the above-mentioned statutes the amount of said
taxes, together with penalties, interest, and costs that may accrue in addition ther~to, is a lien in favor
of the United States upon all property and rights to property belonging to said taxpayer, to wit:
"STRICT
NAME Of TAXPAYER
hPC. ~n.]" ~ciama
~EiiIDHJCE OR PLAr:E OF BUSINESS
612 S h St. Ft. Pierce Fl.&.
TYPE OF TAX AND PERIOD
(a)
ASSESSMENT DATE
(bl
AMOUNT OF
ASSESSMENT
(d)
REFEUN::E NO,
(e)
1960 IT
1960 IT
11-24-61
5-1.2-61
237.04
62.-7-T- 910
.62-3-T-232
110.39
PLACE Of fiLING Clerk, Circuit Court
St. Lucie County
Ft. Pierce, Fla.
TOTAL $
347.43
WITNESS my hand at
West Palm Beach, Fla.,
, on this,
the
8th day of
April
, 19~
DISTRICT DiRECTOR OF INTERNAL REVENUE
Collection Manager
, TITLE ---
Laurie W. Tomlinson
{NOTE; Cerf:rco~e of off:c~r authorized by low to toke acknowledgments is not enenfial to the validity of Notice of Federal Tux Lien G.C.1,\. 26.419, C.B.
19)0,51, 125)
PART 1 - To be retained by recording office
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