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Fefm 668 U. S. TkEASURY DEPARTMElJT - INTERNAI REVENUE SERVICE
fREV. NOV. 1961) NOTICE OF FEDERAL TAX l~IEN UNDER iNTEitNAL REVENUE LAW5
DISTRICT SERIAL NUM6ER
JACKSONY~} FLOrRIDA
Pursuant to the provisions of Sections 6321, 6322, and 6323 of the Internal Revenue Code of 1954,
notice is hereby given that there have been assessed under the Internai Revenue laws of the United 5tates
against the following-named taxpayer, taxes iincluding interest and penalties) which after demand for
p~ayment thereof remain unpaid, 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 thereto, is a lien in favor
of the United States upon all property ond rights to property belonging to said taxpayer, to wit:
NAME OF TAXPAYER
1'' Z'Btllk (~OOd
R~lDENCE OR PLAC~ OF BUSiNE55
].401 ~3rd Street Fort Pierce Florida
TYPE OF TAX AND PERIW l~SSESSAAEM DATE REFERENCE NO. AMOUNT OF
ip~ ~b! iw
Idl
1040A Income 12-31-64 05-19-65 349-09-859~+ ~ 111.63 .
F!l ANa R GOR~Ep
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. = ROGr~ ;=u,T;;' CLERK
~ , ' ST'. L.UCIE C UNTY
- FLORI ~
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,
~ PiACE OF FIUNG
~ Clerk~ Circuit Cowrt
TOTAI. s ~,u.63
SL. j+»C~Q CAU3'lt~
Fort Pierceo Florida
WlTNESS my hnnd at y~'st Paln~ Beach~ Florida .
, on thi~,
~ 2pth day of October . 196c
~
DI571t1GT BIiGECTOR OF IMERlV/11 REVENt1E ~tun) ~ TITiE
F . $ . $CHACID'1.' Csr'Otl $Lt ="ti. aG
~,pO7E, ,p{ ~ cultwriz~d by low to tafus ackrawisd~rr~nta b not s~ntial to th~ vclldity of Notfa of hdnnl Tax LMn G.C.J16. ~6419~ C.O. •
196031, 126.~ ~ R ~~Q i
FART 1- To b~ rftain~d br nconlln~ o(Rc~ 608!( .i.i.rt7