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Fona 668 U_ S. TREASi1RY DEPARTMENT - ~ntERN~~ REVE?+uE SERV~CE Fa Opr,aal Use Br Reco.d~..g 0~ :e
(REV. 8-67) NOTiCE OF fEDERAI TAX l1EN UNDER INTERNAI REYENUE IAwS
DISTRICT sERin~ No. ILED ANO RECORDED
Jaelcsonvills Florida~ _ T. LUCIE COUNTY. FLA.
Pursuant to the p~ovisions ai Sections 6321, 6322, ond 6323 of the Internol Reve- F~~ E'^~~~
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n~e Code, notice is hsreby given that thare hove been ossessed under the Internul ~
Revenue laws of tF~e United States ogoinst the following-nomed toxpayer, toxes p1 ~
(includi~g interest and penalties) which after d~mond for poyment thereof remain ~70 ~'~Y ( Z fP~ S~
unpoid, ond thot by virtue ef the ubove-mentioned statutes the amount o( suid toxes, ~
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togeth~r with penolties, interest, and costs thot may occrue in addition thereto, is ~
o lien in iovor of the United Stotes upon oll property and rights to property belong- +3(1': ~(,ITE?,~.$
~ny to so~d toxpoye~. L~RK Cii2CUIT COURT
NAME OF TAXPAYER
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RESIDENCE
P.O. Boz 1T66~ Fort Pierce~ Flrorida-3345~
CLA55 OF TAX UNPAID BALANCE
~ (Tox Return Form No.) PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
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~ 92,1 3-31~9 7-1~-69 59-1156160 46.68
i 9lt7. 6-3~-69 9-19-69 " 41.42
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~ PLACE OF FILtNG C ~it CO~it't
~~t'Y TOTAL S
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WITNESS my hand at VeBt. Pa11 Bead1. P'l~ , on this,.
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the 6~'? day of ~Y ,19 TO
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~ SIGNATU TITIE
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'~IO~ti C?• Qli~~i j
~ ~HOTE~ Cerrificote oI o(fic~r outhori=~d by low ~o tok~ ocknowledymsnts is not ~ssent~al to the ~al~d~ry of Na~c• of F•de.al Tox Lisn G.CJA.
26119. C.B. 195P51. ~zs.~ a~K184 ~~s~.7
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PART 1-To be retained br recording office
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