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Perm 66t U. TkEASURY DEPARTMENT • INTERN.4t REVENUE SERVICE
(REV. NOV. 1961~ NOTiCE OF FEDERAL TAX LIEN UNDER iNTERIdAI REVENUE LAWS
DISTRICT SERiAI NUA1aER
JACESONYII~I.E, FLORIDA ~ _ e~ ij • ~ ~ ' ~
Pursuant to the pravisions nf Sections 6321, 6322, and 6323 of the internal Revenue Ca~e of 1954,
notice is hereby giver~ that there hQVe been assessed under the Internal Revenue laws of the United States
agair?st the following-named taxpayer, t~xes lincluding interest and penalties! which after demand for
payment thereof remain unpaid, and that by virtve of the above-mentioned statutes the amount of said
toxes, together with penalties, interest~ and costs that mQy aarue in addition thereto, is a lien in favor
of the United States upon all property and rights to property belonging to said taxpayer, to wit:
W1ME OF TAXPAYER
a o n.ni~
RESIDENGE OR PLACE QF BUSlNE55
e M vs ~rt erce lori
• TYPE OF tAX AND PERIOD ASSESSMENT DATE REfERENCE NO. AMOUNT OF
(a) (b) ASSESSMENT
~dj
i
941 ~tithholding o3-31-65 06-11-65 59-~~~+~'S 5 69.6$
941 Withholding 12-31-6~+ , 03-11-6,5 59-~~!~ 132•52
FI ED A R C~R@Eii
! "1
~OOK
~65 /;llr; 5 p 3 ~
? ' 3y
~~z~E
R0~7 LUCi~j., ~ .
r c
FLORID ~~TY~;-=--. .
.f - r
~ _ 1 1i . ~
- ~
~ ~ ; •
~ ' ~e'w t' '~r' .
~ t ' ' t.
~ PLACE (?F fIUNG
C1QX'~L~ C+~rQ1l~t Cr~u!`~. TOTAL S ~~~L7O
St. L~ci• C,quaty
Fort Pierce~ Florida
WiTNESS my hand at ~Idat Pe~la BsaCh~ F"loTida on 4his,
~e 20th day of ~~~t 19~
DlSTRICT DIRECTOR OF IMERNAL REVENUE BY n~ TITLE
Cj/
F. S.~T Thosaa C. (~ra~rt~ (~ou 8u rviaar
{NOTE: CertificaN of off~te~ outhorized by law to take ock~oviledgrr~n!s is not essentiol to the ralid~ry of Notiu Lisn G.C. C.&
1950•51, t 2s.i pqRT i- To b~ r~tain~d br rscordin~ offic~ 90G~K
_ . .