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Fo~,~ ~S U. S. TREASURY DEPARTIAENT - n+TEa?+~~ aEVENUE s~~::~~ Fa or~.o4.~ uH er RK«d.^s a+.«
(REV, &67) NOTICE OF FEDERAI TAX IIEN UMDER INTERNAt REYENUE tAw p qt~D FtECOROED
CISTRICT SERIAIN~. , t~Ci~ COUNTY, FI..A. ,
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d~CS01~~11~~ FZ+Or'~,di _
Pursuont to the provisions o( Sections 6321, 6324, ond 6323 of the Internol Reve-
nue Code, ~otice is hereby given thot there hov~ Men ossessed under ~be Inter~ol (j~~7 '
Revenue lows of the United Stotes ogoinst !he following-nomed toxpayer, tdc~ ~1: ~ 5 ~~1
(includinp interest ond penolties) which oft~r deaand for poyment thereof remo~n
unpoid, and that by virfue of the above-mentioned stotufes the amount o( soid tozes,
togeth~r witti penalties, inte~~s1, ond costs that ~woy occrue in addition thereto, is -.~~;-a;,~
.
o lien in iavw of the United Stotes upon oll property and riyhts to properfy belony-~ ~ Cl~n~IT C~URT
ing to said raxpoyer. ' ~ «
NAME OF TAXPAYER
F.~~ ~N~ 1liRl'~.8 $e~CA s~t'i3AY1
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RESIDENCE
5001 9outh Federal Highnray
Fort Pisres~ Florida-331t50
CLA55 OF TAX UNPAID BALANCE
I !Tox Retutn Form No.) PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
(01 (b) ) {d ) (e ) _
I
f 9l~1 3-37t68 ?-25-69 59-11b31a54 313.19
~ 941 9-3~ 8-29~-69 • 309•32
~ 9};1 12-31r6~ 7«25-69 • 387.69
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~ PLACE OF FILING C~~~ CiTCll~t, (i~pu?'~
$t• L1iC~A C01Ult.~ TOTAL S ~,~Q]A~2Q
v; Ft.• PierOA~ Fl~?• I
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ti+d~TNESS my hand at LTs~t Pa1s B~ac`-h?,~'*~'ids ~ , on this,. !
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^;g th e 26th day o f February ~ ~q 70
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; SIG E TITLE
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aroup Supsr~ieor
Tbomas C. Graves '
^r?~ (NOTE: Certificon of of(iur outhori:~d by low to take otkoowledyms~s is not ~ss~ntiol to the volidity of Na~c• of F•d..el Tox Li~n G.CJd. ~
: 26119. C.B. 195051. 125.)
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F::, PART 1-To b~ retained br recording office
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