HomeMy WebLinkAbout0943 - - ~ _
Form 668 U S TREASURY DEPARTMENT - ~v~E4N~: o~vE!~~'c S£o•/~CE ~ -_..lu ,
~E: iivii~E 0~ FEDtKni T~ii iiEi~ unuER iriTiRh~i iciiii~iili ii?i~ii
D(STRICT SERIAL NO_ F ED AND RECORDEDy
Jacksonville, Florida ST IUCIE COUNTY. ~LA.~
P~rsuont fo the p~ovisionc a( Sec~~o~s 6371, 6??2, ond 63?l ~f tl+~ ~.:~...,,,i R.,,._ RECORD VERI~IED
nue Code. notice is herebv oiven thot there hove been assessed under the Internet ~ ~Q~~O
Revenue lows of the Un~~ed States ogoins! 1he (ollowing-nomed toxpayer, toxes
(including interest ond penalties) which ofter demond for poyment thereof re:no~9 py 28 PM
unpaid, ond thot by virtue of the above-mcntioned stotutes the amaunt of soid toxes,
togeeher wifh penalties, in}eresr, ond costs thoi moy occrue ~n ado~~~o~ thereto, is ~
a I~en in iovor of the United States upon o1) property ond rights to property belo~9- ~ ~rF ~
~ng to soid toxpayer. {.l..~~R . OtTR~'~$
- RK CIRCUIT COURT;
NAME OF TAXPAYER
C. Carl McCormick
RESIDENCE
General Delivery .
Ft. Pierce Florida 33450
CLASS OF TAX UNPAlD BALANCE
(Tax Return Form No.) PER100 EN'JED ASSESSMENT UATE IDENTIFYING NUMBER OF ASSESSMENT
(o? (b) (c 1 (d ) (e?
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` 1040 12-31-67 7-11-69 250-54-3824 1,204.15
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~ PLAC~ OF FILING
~ Clerk of Circuit COUrt TOTAL S 1,204.15
St. Lucie County
Ft. Pierce Florida 33450
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° wITNESS my hand at .L nvi11Q.~Florida , on this, 4
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the~th__doy of Nov mbpr ,19 69
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Chief, Office Group ~
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tNOTE: Gr~ificote o~ o iur oo~hvized by lawr to ~oke acknowledym~nts is not ~ssentiol to the val~d~ry oi Naic• of Fed~rol To¦ Lieo 0.CJA.
~ 26119, C.B. 195051, S.) ~
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PART 1-To be r~tained by recording office
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