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Fo„a 6Ga U. S. TREASURY ~EPARTMENT - INIERNAL REVENUE SERVICE Fer Op~on~l Ux !Jy Rcco.d~eq df.ce
(REV. 8-67) NOTICE OF fEDERAI TAX IIFN UNDER INTERNAI REYENUE IAWS
DISTRICT SERIAL NO.
Jacksonville Np RECORDE~
Pursuont to the provisions o( Sections 6321, 632I, ond 6323 of the internol Rew- F LED IE ~OVNTv' F~.~ '
Revenuee,laws'cof 1thee United vStotes ta i at the foilowsn e-na edntox e~
n toxes S• sLV
~tt~' vE
90 9 PaY
(incl~din9 interest ond penolties) which ofter d~mond ~w poyment thertof rsmain ~QQr~(]~
unpoid, ond thot by virtue of the obove-mentioned stotut~s the omovnt of soid toxes, ~~p~'~~~Y 50
to9~thK with penotties, inte~~st, ond costs that mar occrue in oddition thsreto, is,~ n ' f~
o li~n in fovor of the United Stotes upon cll property and rights to propeHy belonp-~"
in9 to soid toxpay~r.
MAME OF TAXPAYER ~:QC E~QL7RF~S
John D. & Rachel Washington ~~{~K~ CIRCUIT ~OVRT
RESIDENCE - -
1605 11erth 1Stti Strsst _
~ort lisre~, ~lorida 33i50
CLASS OF TAX UNPAID BALANCE
(Taz Return Form No.1 PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
~o) ~b) (c) ~d ~ (e)
lol~0 12-31-~ 5-3~9 213-26-2070 ~335.09
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~ PLACE OF FILING C1eY'~C~ Circuit Court 335•~ f
~ S'fi• I.11C~@ C011tltiy TOTAL S ~
~ Fort Pierce, Florida
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~ WITNESS mr hand ot West Palm Rea~h~ FLnri~a ~ , on this,.
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~ the~h._dcy o4 .Isnuarv ,19.,70 ~
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~ SIGNA ~ TITLE
GROUP SUPERVISOA
~ (NOTE: C~rti(icot~ of of(ic~r ovthoris~d br lor~ to tok~ ocknewledym~~xs is not ~ss~ntiol to tM volidity of NWit~ of f~daol To: L~~n G.C.M.
~ 26119, C.B. 195651. 125.) (10~~ ~ fl~ ~ ~
~ 8 0
~ PART 1-To b~ ratain~d br ncording offlu
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