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Fii~ bbi U. 5. TRE/15tlICY D~/?ATMBd~ - INfERNAI REVEMIE SERVIGE hr OM?rd IM h bar~'~M OIIfw F
«v. ..esi NOTICE OF FEDERAL TAX LIEN UNDER INTERNAL REYQIUE LAWS FILEO ANO R~~~pRDE~ `
asrru~ sea~u wwu?eet ST. lUC1E COUNTY. FLA. ~
acksomille~ Florida R~COR~ VERIFIED j
pursuaru to ths provisioro of Secrions 6321, 6324, and 6323 of the Infemal Rwsnw C.ods, ~~]'Va7 ~ 4 ~
notice is hsreby ghron tF~ot thsrs havs b~sn ass~ss~d ~ncl~r ths Intemal Reve~ws lavrs of ths M 1 (r
Unifed States a~oinst ths following-nomsd to:payer, lcxes (ind~dinp infer~st and p~naities) which ~ A~ I 0 AM 9: 3 g #
afier d~nand ior payma?t thereof remain w~poid, and Nwt by vUtve of ths obov~-ms+itanxl ~
stotutes ths omaint of soid toxes, together with psnahies. iMerost. ond oosn thot may ocuvs C~t.~~~ i
in addition fl~snfo, is a lien Tn favor of tM Unifed Sfafss ~pon ail pnopeAy cnd rights to propeAy Q a~-- iJ ~~Q ~TRl: S
b.~,~,,,~ CLERK CIFtCUIT COURT
NAAAE OF TAXPAY9t - ~
FORkFST R. & IiAZEi. J. JORDAN ~
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aesioa~ce oa awc~ oF eus~r~ss t
5gOq S. Indian River Dr., Ft. Pierce~ Floricia-33l~5~ ~ '
aA55 OF T/1X UNPAID BAlA1JCE
(Taz Rettim Form No.) PERIOD BdO~ ~455E5511l1B~IT W1TE IDEMIFlfING NUMBER OF ASSESSMB~IT
Ial (b1 (d ldl le1
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~ io4o 12-3]t66 6-23-67 370-03-5019 1,615.52 ~
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~ ancE oF AuNG e s ;
~ St. Lucie County ~T,~ = 1,615.52 '
~ Ft. Pierce~ F'la. .
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wITNESS my hond at Weat Paln Beach, FlArida , on thi:.
the 7~ day of au~t ,19 3_
DISTRICf DIRBCTOR OF MfTE11NK REVBrIJE SY T~ -
A.J. 0'Donn~ell, Jr. ~ (~roup Supervisor
(NOTC, CKeifioote of offbK avNiorisd b~r low b od~r~owlsdprn~s b nd ~as~t~tial wlidlt~? oi t~blics of f~dud Tax Wn G.C.NL
26419. C.S. 1950-51, 123.) - - ~
ART 1 To b~ nloin~d b~r nardin~ efNa Slj(jK PA6E ~i10~
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