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For~ 668 U. S. TREASURY ~EPARTMENT - iNTERNnI NEVENUE SERVIGE N Uw By R«o.d~ OH:c~
(REV. &6'7) NOTICE Oi iEDERAL TAX tIEM UNDER INTERNAL RE~ENd Q~NTY. Ft:A.
DISTRICT SERIAI NO. uFit~lEt~
C f? ^
Jacksomrille Florida ~ ~ ~88~~3
Pursuont to th~ provisions of Sections 6321, 632~! a?d 6323 of tM lot~rnol Rev~-
nw Cod~, noiice is h~rsbr qiven tlwt th~rt hov~:_ ~t~n oss~ss~d und~r J4* Int*~1 q ~ 9, 26
R~venMe lows of the United Stot~s oqoinst th~ -followin9-nom~d toxpa~jrur ~i~~s ~
(includiep int~rest ond penolti~s) which oh~r d~~ipnd for porm~nt th~r~of remoin
uo p oid, ond ~hot b y virtus of th~ obov~-a~ntioned stotuNs th~ umount of soid tox~s. ~ ~'~~N
to9ethK with ptnolties, inter~st~ ond costs thot i~wy qcerw in oddition thereto;v~ -
o li~n in iavo~ of tM United Stot~s upon all prop~rty and ~iyhts to prop~rtp ~j~K C~ cu~Y couRT
in~ to soid toxpay~r.
NAI~AE OF TAXPAYER
gll~y ~ARMIN, JR. -Earls Service Station .
RESI~ENCE '
5001 S. Federal HWy., Ft. Pierce~ ~'loiida-33450 -
CLASS OF TAX - UNPAID BALANCE
(Tax Rtturn Fwm No.) PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
(o) ~b) ~c) ~d~ ~e~ ~
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' 9A1 ~-3~9 12-12-69 59-u63454 953•75
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~ PLACE OF FILING ~ OL1Y'
~ $ti• TstiC~B CiOUllti~
TOTAL s 953~75
~ Ft. Pierce~ Fla.-
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~ WITNESS my hand ot West Palts BeaCll, P'lol'ida ~ a, ~,~s~_
the~_dq of J$~ ,19 TO
~ SIGNATU ~ TITLE
~ aroup ~perviaor
'!'6o~s~ C. Orrr~s
MOTE~ C«riftcor• ef eftjcsr o„~horis.d by Im,r ~e ~ok• acknewlsd9~..~xs ls na .sa•m~ol ~o N~. ~ol~di~r of Natc• eF F.d..el Tax Li•n G.CJiA.
~ ~19, C.B. 195051. 145.1
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~ PART 1-To b~ ntain~d by ncordinq offic~ . '
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