HomeMy WebLinkAbout1424 Fornt b68 U. TREASURY bEPAkTME~1T • INiERNAL REVENUE SERVICE For Opriawl Us~ ~r R~caedinp ONic~
{eEV. a-65~ I NQTICE 0~ FEDERAL TAX LIEPI UNDER INTERNAL REIIENUE LAWS ~ -E~O flED
DISTRICT I SERIAL NUMBER r ~~l~~~O~g00K
------Ja~kson~-'_Ile~ _~''l.orida------------- ~ ~
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~ Fursuant to the provisions of Sections 6321, 6322, ond 6323 of the Interrea! Revenue Ccd~,
n~ti;c is hereby given tho: ~he~e h:ve bee~ assessed under the intemal Revenue I~ws oi tFa ~ (~~'~T 2 O 5 a
Un'ted States against ihe f.;l'ow!r,~_nnme~ to.payer, taxes (induding interest or.d penolties) wh~cn
after demond for payment tF~ere~f rem.7~n ~~npaid, and that by virTue of the above-mentloned y~~ ~
stotutes the amount of sa`d t~ ~ ,~~~:'~er v:~~h penolties, in!eresf, and costs thct mav accrue
~r c~~'tion±hereto, is a I~e~ in cf ?f,e Unitz~ Stores u~cn ~!I property and r!ghts!a p:operty i::"'^~• LLE~K
be;org~ng to said tazpay^~r. !l{ll:~~G~. ~C.~rUPJTY,
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NAME O: TAXPAYER
~P~d Trorli ~ r . ~'J1I't3
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F~S;DEtiC~ OR PLACE OF BUSINESi
?_7?7 5~.:~.r~.se ~1~*d.~ Ft:. ~i~:rc:.~ :7_~rid~
CLA.55 OF TAX I UNPAID BAI./WCE
(Tc>: Rerum Form No.~ °ERIOD ENDED ASSESSMENT DR?E I ID:tJTiFYING NUMBER OP ASSESSMENT
(a1 Icl I ic) Idi I lel
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lt?Ln 12/31!~+~ .ri-2fi-~S ?~15-2!,-1~l21 ~.i229.80
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PLACE OF FIIING ;;lerk, !~i?^C',11't, CO'dT't
jta Lucie v0~.).T?~T TO?AL ; ~F)~2/~~~~
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P}. erce' ~'lo*_~ida
WITNESS my hand nt `.''e st ~'aL~ Beac"~, ~'lorida
, on this,
the ~7 t!~ day af ^c ~~bQr , ~q ~5
UiSTRICT dIRECTOR OF INl'ER1`!AL RfVEF1UE SY ~ rtatvro~ T~T~
. y •~J• ~?L+r•T:`.~-(~'t /J~ tT~u~ Supervi.sor
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(NOl'E: Csrtiflmte of efficer avthorized by law to take acknowlsdgments ia nof essential to the validity of tJotice of Faderol Tax lien G.GM
26419, G6. 1950-51, 125.)
PART 1-To be retain~d by r~cording of~ics ~~~9-