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F~ U. S. TREASURY'JEPARTIAENT - INTERNAL REVENUE SERVILE fw O~e:o~l lp~ B~ R«ad.q ON~c~
(qEV. 8~67) NOTICE Of FEDERAI TAX LlEN UNDER INTERNAL RE11EIqlE IAwS
DISYRICT SERIAL NO. FI E~ AND R~CORDED
Jacksomrills~ Florida ST. UCIE COUNTY. FLA.
' Pwsuont to tM p~ovisions of S~ctions 63~1, 63M~, and 6323 of th~ lot~.n~l R~w- !~.'~R~ V~R1~'r ~ ~
nue Cod~, notic~ is h~r~by giv~e thot th~r~ Mv~ b~~n assess~d vnd~r th~ Int~rnol ~Q C~
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R~v~~i lows of tM Uoit~d Stotes oqainsf .th~ ~lollowiny-rwmtd toxpoy~t, rox~s ~ q
(Includin9 int~~~st ond p~nolti~s) which oft~r d~AOnd fw poynMnt thereof r~ena~ J~~ 30 ~ GS
~npoid, ond thot bp virtw oi th~ abow-nwntion~d stotut~s th~ amount of soid tox~s,
topetl~r with p~nafti~s, int~r~st~ and costs tlwt w~iy accrw in oddition th~r~ro, is ' j
O li~n in iava o( th~ Unit~d States upon oll op~rty ond ri hts to !
P~ 9 Prop~.tY b~lc+w• rir-? i-C~iT :.S ~
io9 to said toxpay~..
NAME OF TAXPAYER RK CIRCUIT COURT ~
FR,ANg GOOD * al~aster Sign .
RES{DENCE ; ~ . `
P.O. Box 582~ Ft. Pierce~ Florids 33~,5~ ~ ,
. . 4.
CLASS OF TAX = UNPAID BALANCE
(Tox R~turn Form No.) PERIOD ENDED ASSESSMENT D/lTE "10ENTIFYING NUMBER OF ASSESSliAENT
(a) ~b) .k) (d)
' 91a. 6-3~9 10-2269 59-1105298 1,062.40
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PLACE OF FILIHG C~~' C~u3L COUl"~.
St.• L11C~.A COUIItp TOTAL i 1~062~~0
Ft. Piercei Fla.
WITNESS ~ny hand w iiTest Palat Besah~ F1~orida , on this .
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the~#r~L_day oE J8nu8r4 ,19 70 - ~
SIGNA TIT lE ;
' n.vd ~L- • - arauP 3upervisor ~
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MOTE: GrHfieet~ af eHie~r artlwrissJ by I~w te tdn eeknewl~dy~rrs is nM ~ss~Miei to tM voliditq d NMit~ J F~dK~I Tu Litn G.C~A. .
?b~119, C.B. 195051, 125.) -
PART 1 To b~ nfain~d b~? ncordiny offic~ - d~ ~S~ _
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