HomeMy WebLinkAbout2108 - G
-1 form 66a U. S. TREASURY DEPARTMENT - 1NiERN~~ REVEN6~E SERVIGE Fa. Op~.o~o! U:e e~ Rccs j~ C1~~ce
;REY.a.ar, iiOiitE Q~ ~EDEitAI TAX liEli i1iiDER ii~TERii~l ~EYEtiU~ L~Wi ~~-~D~-'~R~_.!
DISTRICT SERIAL NO. ~.•,~-UC~~ CQ.U'N ~Y~~I,.1:. .
Jacksonville
Pu~suont to the provisions of Sections 6321, 63??, ond 63Z3 oF ~he Intsrnol Re~e-
nue Cods, notice is herebv ~ven that thare hove be~n assessed under the Intarnol ! q ~f •
R~v~nw iows oi the United Stotts o9oinst fhe followin9-nomed toxpayer, toxes ` S'~ 35
(including interest ond penolties) whicb after der~nd (or poyment thereof rsmain
unpoid, ond thot br virtue of the obove-mentiontd stotutes the omount o( soid tox~s, ~
togeth~~ wit6 penalties, iMe~~st, ond costs thot nq~i otcrue in addition th~aeto, is ^'J~~!`$
o lien in iavor of the United States upon oll property ond rights to property belonp- ~-=R~ ~iRCUt~ COURT ~
ing to soid toxpoyer. ~
i
NAME OF TAXPAYER ' i
aee88 F. ~ i,o,~e e. c~~ , }
~ 1
RESIDENCE ~ ~
Rt 1 Boz ?28
Fort Ff.erce~ F]Arida .
CLASS OF TAX ~ UNPA10 BALANCE
(Tax Rsturn Fwm No.) PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT~
(ol (bi (c) (d) (e)
l040 12-31t67 5-37.-68 262-2a143o i 153.39
i iot~o 12-31~-~8 5-23-~9 262-2aiti3o 887.5?
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~ PLACE OF FIUNG C182'~C~ C~I'Ctl~t. CO11I'ti . O~jO•
$t.• L11C~e COti11t.~ TOTAL i ~ ~
FOTt. ~AI`C9~ ~02'~@8
WITNESS my hand at West Pe]m BeaCh~ Flo2"id8 , on this,-
the 21st ~y of October 19~
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SIGNA7U ~ TITLE
~a~?s c. e~vss ~ . c~,ouP su~a~vrsa~ ,
MOTE: C~.tificot~ ef oif;c~r ~u~hari:~d by Iaw to toke eckner.l~aads is not ~ss~retiol to tlr voliditr ef Nofle~ d Fe1~ra1 Te~c Li~n G.CyI.
?4119, C.B. 195051. 125.)
. S~K~~o ~~.a5
PART 1-To b~ ntain~d br ncording offic~ '
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