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Fbrm 668 • U. S. TREASURY OEPARTMENT - ~NtEa?~~~ aEvENUE sE~•: t:E Fo. ON•awl Use e~ R«wl.~.y W~~ce _
,REv a-3r. iiOiitE Of ~fDERAi TAX UEN UN~E~ i~ITE~NAt KEY~NuE tAMS RECORDEO' .
DISTRICT SERIAI NO. FILQD AND
T. LUCIE COUNTY. FLA.
Jackeonville~ Florida ~F r,nRr v R~F•.E~
P~.suont to ?F+s p?~~~sions o( Sectio~s 6321, 6322, ond 6323 of the I^ter~~l Reve-
nue Cods. notice ~s herebr oiven thotthere hove been ossessed under rl,e Internol
R~venw lows of the United Stotes oqoinst the (ollowing-nomed toxpoyer, tozss ' Q pM 3• `s
(includin9 interest end penolt~es) which ofter demond for payment thereof remein Q~C ~
unpoid, o~d thet by virtue of the obove-mentioned stotutes the omount o( soid to~ces, 6
toye~he~ with penoities, interest, ond costs thot moy occrue in odditio~ thereto, is
o lien in iovor of the United States upon otl property and rigF?ts to property belong- r F' Ra5
~~g to :a~a ~ax~ye.. CLERK C1RC IS COURT
NAME OF TAXPAYER
CARL F. WHITE
RESIDENCE
P.O. 3ox 672~ Vero Beach~ Florida-32960
CLASS OF TAX UNPAID BALANCE
(Tox Return Form No.) PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
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10I~0 12-31-58 6-20-69 2.h7-t~8-292I~ l, 282.92
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PLACE OF FILING Clerk, Circuit Court
Indian River County TOTAL s 1s282•92 <
Vero Beach, Flo~ida ~
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WlTNESS my hand at Waat Palm RRar' ~'lnrirt~ , on this,. ~
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the~_day of December ,19 69 ~
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SIGN E TITLE ~
Qmup Supervisor ~
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OTE: Certificats of oFfic~r outhori:~d by Ivw fo ro4~ ocknowl~dynMms is not ~ssentiol to tht rolidity of NMic~ e( F~d~~ol Tox Li~n G.C.MI.
~i9, c.s. i9sas~, izs.t
~ d00K~V~ PACE~J~c~
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PART 1-To be relained br recording office
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