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~t U. S. TREASURY DEPARTMENT _ IME~IAL REVENUE SERVICE Fa OpKeeel U» tr booediy ONics
.(REV. 4-65) NOflCE OF FEDERAL TAX UEN UNDER IN1EitNNAI REYENUE LAWS
DISTRICi N~~ ILED AND RECORDED'
Jaeksow~rill~ llorida . LUCIE ~OUNTY, FLA.
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Punuant to the provisfo~s of Secriorn 6321, 6322, and 6323 of tfie Internal Revenue Code, lsc~404
norice is hereby g:ve~ that there have been assessed under the ~ntemcl Reren~e lows of the Q :
Un~ted States agoinst ths following-nomed roxpayer, roxes (induding inrorest and penaltiesl wh~8 f EB I 5 PM v i
after dernand for payment thereof remain unpaid, ond that by virlve of the obove•mentioned _'r' ~
srotutes the artaunf of wid toxes, together with penalties, interest, and cpsts thof may occrve `+y ~
in addiYqn tlxreto, is a lien in favor of the United Stotes upon all propsAy and rights ro properfy :._t~ ::V~'TF?,•,S
b`i°"9'"9 w~'a ro"p°''~.. LERK CIRCUIT COURT
NAME OF TAXPAYER ~=i~ IAe S~!!d
~sio~cE at aACe oF susu~ss 3009 1?w. D .
l~t. tierc~, Fl~rida 33~?SO
a~ ~ T~ UNPAID BAIANCE
(Tax Retum Fortn No.~ PERIOD ENDED ASSESSMBVT DA7E IDEM'IFYING NUMBER OF ASSESSMHJT
lal Ibl k{ idl le) 3
10i0 12-31•6S 7•14-67 267-8i-3113 i4~.96
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~ ~ Au~ Clark of tha Circrit Court 643 9i
- Cq/fl~ Of St • 1.tIC~! TOTAL = •
sc. !i•re., rl•riaa
~ WITNESS my hand at J~~nnllt~ lrl~tida
on ihis,
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~ the 8t~ day of 19 67
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, DISTRICT DIRECTOR Of INTERNAI RENBJUE BY TITLE
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(MOT~ Ce?tifioots of of(icar avMarized by law ro toke adcr~owl~nenfs ls nd essentiol ro wlidity of N~o~ Tax L'
~ 26419. GB. 1950-51, 125.) g~~ ~S~
; PART 1-To be rN~ainad b~? ncording offics
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