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Fons 66~ U. 5. TREASIIRY DEPARTAAEM . IMElMK ~AIE SERVKE hr GM~rd Un ~l R«aJty ON1a .
~-43) NOTICE Of fEDERAL TAX UEN UNDER INTERNAl. REYENUE LAMIS FILEO AND RECORO D
DISTRIGf sE~u~ ST. lUC1E COUNTY. ~~A.
J/1~ESONVII.Lg, FLORIDA I RECORn v~RIFiEp
Pwsuorr ro ths provlsions of Sectiorts 6341, 6322. and 6323 of th~ IntKnol Rrrsnus 161'769
ewr~cs is hueby ~ivse thar M~ere havs been osseusd under ths IntKnol R~ve~ws laws of ~ ~T NOV ~ v I"17 S 9
United States opoirnl fhe folbwing-namsd eoapoyer, toxes (lnclvdirg Inlerrst and penalties) whkh •
afrer demoed for payrt~eN thrwf ~emo~~ w+poid, cnd thot by virfw of ths abav~-mk+tansd .-~~~C7ti~
srotutas ths onww?t of sa~d ta¦es. togerher w~th penolries, irMerest, and aosfs tfiot may acws
?n odd~tion theret-~, h a lim in f6vw of the United Srotes upon ali propeity and rights to property tZ~G~R t OITRAS
w~~d a~._ CLERK CIRCUIT COURT
?:AME Of TAXPIYER ~
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Dg~~i dt ~u~ ~
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R~~iDENCE OR PLAC~ QF bU51NE$S
a't 3 Ha~ 462, Fr. P~CS, FI.d. 33450
---CLASS OF TAX UIdPAlO BAIANCE
(Tax Retum form Nc.) PER{OD ENDED ASSESSMHvT DATE IDB~lTIFYING NUMBER OF ASSESSMfM
{aI Ibl !d (dl 1~1
1040 L2-31~5 3-31-67 ~ 26?
21,~-5664 56.11
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( 1o40A 12-31-66 6-02-6? 267-2~-566ra 975.20
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PLACE OF FlUNG
Ci~s Ci~U~ CiOj~ TOTAI s i,o3i~~ "
s`P. T.VNiCr WV~ii
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WITNESS my hand at MIA~Q. FT~DA , on this,
the 9~ day of 19 67
~~s*~icr aa~oa oF i~ r~v~ue sY Is~s~+~+~N Tir~
A. J. O~DOIA~Id., J8. aCF SiJPBxYI3Qt
(t~'OT~ CertifioQes af offlcK authorizad by taw a sak~ adcnowl~d~menls Is rwf ess~nNal ro the idity of Not~ce of hdera~ To: lia~ G.C.M.
26419. G8. 1950-51, 125.)
PART 1 To be rotain~d bp ncording offic~ Q'QK169 PAGE tj~~
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