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form 668
-
U~R~
8G~1,
FE~~~~~5~:XDE~~~\[~~~~;A;~~V~~i1~~MNUi! ~A W~ ^.
60 tl,':~' 521
(REV, NOV, 1961)
NOTICE OF
81SUICT ]SHIAl NUMBER
______ .r,.Q.}csonv1.Ue ~a. __
Pursuant to the provisions of Sections 6321, 6322, and 6323 of the Internal Revenue Code of 1954,
notice is hereby given th, t there have been assessed under the Internal Revenue laws of the United Stotes
against the following-named taxpayer, taxes .including interest and penaltiesl which ofter demand for
payment thereof remain unpaid, and that by virtue of the above-mentioned stotutes the amount of said
taxes, together with penalties, interesT, and costs that may accrup. in nc-lrlitinn thprptn j<; n lien in fovor
of the United States upon all property and rights to property belonging to said taxpayer, to wit:
NAME OF TAXPAYER
__ ,Geora.lk_LEthe1 M. Metz
RESIDENCE OR lllACE OF 8USINESS
F'la
TYPE OF TAX AND PERIOD
(0)
ASSESSMENT DATE
(b)
REFHENCE t<O, ~ AMOUNT OF
(e) ASSESSMENT
(d)
I
61-1>-38492 300.17
Addl. 1959 I.T.
7-28-61
PLACE OF FILING
Clerk, Circuit Court
St. Lucie County,
Ft. Pierce, Fla.
TOTAl
$
380 .17
l__u
WITNESS my hand at
West Palm &ach, Fla.,
____, on this,
the 8th
April
,19~
day of
--------
DIST~ICT DIRECTOR OF INT[;;:NAl REVENUE ---- j'TITlE---
Laurie W. Tomlinson -4-] Collection uanager
(N~JTf: Certlfcote of officer (lvthorlzed by law '0 t(Jk.~ acknowledgments is not ~!.ser.flol to t ,e validity of Notice of feJerul lox lien G.C.M. 26~ 19, C.8.
195051,1751
PART 1 - To be retained by recNdirog office
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