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~ ~a U. S. TREASURY DFPARTMB~fi . ihlTEkNAL REVENUE 5ERV!~~E Fw Op~ianol ua. ey R+cord~n9 Offlcv ,y1~
~R~v. <-es~ NOnCE OF FEDERAL TAX IIEN UNDER INTERNAL REVENUE UIWS
DISTRICT SERIAL NUMBER L~ ~~D E 0
I ti.._..__W____._.__ 300K
~ Jacksonvil~.~L_~'Y a. _ ~ ~ .
pursuant to the provisions o~ Sections 6321, 6322, end 6323 of the Interna! Re.•enue Cede, s
notice is Fereby given that the~e have been assessed vnder the Infernol Revenve !aws , ;h~ NOV PM
United States agoinst the following-named toxpayer, taxea (induding interest and pen,lr,es? v~h'ch ~1~
after deroand fo~ payment therecf remoin unpaid, and that by virtue of the ot::ve mer.r,cned tJ
statutes the amount of soid t.nres, fogert:ar wi!h pena~ties, interest, ond costs fh~~r r, ~r; r.ccrue RO G ~ FY t' { t j;, C ~E RK ~
in cdd'tion thereto, is a lien in favcr of the United States upon otl property and ra!,~s ~o properiy
ST. LUCIE COUNTY,
belonging to sa~d raxpaye~. FLORIDA
- - - - - _ - _ - - - - - -
NAME OF T~LXPAYER
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RE5IDENCE OR PLACE OF 6i151NES5 ,
170K Havan~ Av~ ' • y •
~prfi ~.E2'CQ~ r13• `•'u ~`~i•-
- -
C1.ASS OF TAX i „ Ut~}FAIJ~ BI~Y,At~lCE
(Tax Retvm Fortn No.j PERICD ENDED A55E55MENT DATE ~ IDFNT!FYING NU1456ER~'.~' _ OF ~SS~`'.~MB~lT
~a~ ~t~ (c) ~ ldl , ' ~t~, t6:~
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ln.?.~g ].2/?~./.h3 b-23-6K .2.h~-2~-b5?1t ~35.3~a
101~0 1?/31/bf~ K-19-65 2!~~_21~_657ls 733•10 -
~
PIACE OF FIL~t~PG rl o~'~' :;1T`C'1it:~ ~O'~;^t~
~ 3t~• L?)C~~ COLl~ TOTAL ~ ].~slJ~l
F+~ P:i.erce~ ~'1.8• ~ ~
WIINESS my hand at- '•'est Pa1 m R~ar~+~ ~1 a , on this,
the~3#h dayaf Novemher , 19.5~--
DISTRICT D1RttTOR OF INTERlVAL REVtTJUE 8Y r~ 71tLE
~ .3. ~ch.~^idt ~ Group S~ip sor
(NOTE: Certfficate of officer authorized by law to tci widprtwrtts ii not asuntioi to ths wlidity of Notice of Federal Tax L~sn G.C.M.
2e5419, C.B. 1950-51, 125.! ~ R j R/~
PART i-Ta be r~rFait~d by ~cording offic~ g00K l~uv