HomeMy WebLinkAbout0569 ` Fo~. 66t U. S. TREASURY DEPARTn1ENT - iN1Eaw~~ REvenue see ~icE Fe: O~.w1 us. er R«e.awy as~.
:~E~. a.6~? iiOTitf 0~ fEDERAI TAX LiFN UMDER INTERNAi RfiIENUE tAw3
~isTRic ~ seRi~~ No. ~ FtlEO AND REC9R6t~~~
Jackson~ril]rs T. lUC1E COUNTY. FLA.
rt: CnRD VFRIFtED
Pvsuont to tF~~ p~ovisions of Ssc+~ons 6321, 632Z. and 6323 of the lnterml Reve-
nu~ Cod~, notit~ is Mr~by given thot t6sre hove b~~n oss~ss~d under the Int~rnol
R~~•nw laws of t6~ United Stat~s a9oinst th~ tollowiny-nom~d taxpaye~, tox~s ~ ~ +u A• O~
(includiey int~rsst and penolties) whic6 oh~r dew~od (or poyment thereof r~moin & M ~ W9 7 ~
unpoid, ond that by virtu~ of th~ obov~-m~ntion~d stotut~s th~ omou~t of soid toxes, Ia~'~`~ ~
to~thfr wit6 p~nalti~s, int~r~st, ond costs thot nq~i accrve in addition tMreto, is ~ ;
a(i~n in iovw of tM Unit~d Stot~s u oll o rt ond ri hts to propert b~lon • 'ZQ r~R r OITR:,S
inq ~o se~d wxPor••. ~ r 9 y 9 LERK CfRCU1T COURT
NAME OF TAXPAYER
Ra~so~tl L. dc 9usan 3a~sLon .
RESIDENCE ~ C ~~e~. -
2~ p~1~0 Ci01lY'tr
CL/155 OF TAX UNPAID BALANCE
(7oz R~turn Fwm No.) PERIOD ENDED ASSESSMENT OATE IOENTI~YING NUMBER OF ASSESSMENT
, (o ) lb) (c ) (d ) (e )
1040 12-31~-6T 5-17-68 479-32-4934 i311.65 =
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WITNESS my 6and ot Yest AaL Heaa~- Flarida , on this,.
~ th~~~dq of ~r ,19 69
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~ MOTE: G.r~lie~e. ~i ~flie~r wrth~rts~~ ~r le. te tak~ ~eke?«•I~~pww~ms is net ~~s~ntiol re rM .~I~d~hr a~~~~ F~~e~l T~. li~n G.C~. ~
?b119. C.S. HS~SI. 145.1 / / ~ ~'~(1
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