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f~ N~ U. S. T~EAS~lh OfMt1MENT • 1NtEMiAI lEVEt~lE SEtV1CE j.
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' ~~v. r,o~v. ivei~ NpTiCE OF FEDER/1l TAX ~f~l UND~ INTqtNAL REVENUE LAWS
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; Putsucnt to tha provisions of Sectiorss 6321, 6322, end 6323 of !he lntemc~! Revenue C~de of 1954,
notice is hereby given thut there have been cssessed under the Internal Revenue laws of the United Stotes ~ -
; against the following•nomed taxpaye~, toxes linclucling interest and penalties! wfiich after demand fo~
payment thereof ~emain unpaid, and thot by virtueof the above-mentioned st~atutes the amount of said
• taxes, together with penalties, interest, and costs that may accrue in addition thereto, is a lien in favor
i of the United States upon all. property and ~ights to p~operty belonging to scid taxpayer, to wit:
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NAME Of TAXPAYER -
~ ~ J. A. Forbes. Forbea-3Dia N Soaus I.eiundr~?
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~ TYPE OF T/1X AND PERIOD ASSE35MENT OATE It~Fft~i~K.~ NO. MAOI~I! Of
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' 941 Vithholdins 6-63 10-28-63 59 ~?92911 i 2~.?8
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PIACE Of FIUNG .
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: Fort Pierce, Florlda
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WITNESS my hand at Veat Pals Ee~~ Florida , on thit,
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~}~e 20th day of -T,~~~r_,. 19_~! ~ :t~
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oareia aaECrort oF iNr~ ~ sY ~ m~ '':fi
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: IA~RIE v. TOMLINSON y Colleatioa Manager
(NOTE~ G.tifioon of o16a? authorizd by lovr to fab ocknowledpm~ds b no1 ~ste~Niol w thi volidity of Notia of f~ Tox C.M. Z6419 Gd. _
tvso-st, t25.1 ~ ~ 'ART 1• To b~ nMin~d b~r ncording effiu Q(1:~ ~.~4
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