HomeMy WebLinkAbout1699 • Fo~iw 664 U. S. TREASURY UEPARTMENT - INTERru?~ REvENUE SERV~CE Fo/ ON~aMI us~ 8~ Reca.Iwy W~e ;
(REV. &67) NOTICE OF FEDERAI TAX l1EN UNDER INTERNAL REYENUE tAwS FILEO AND RECORDEO `
DISTRICT SERIAL NO. ST. LUCtE COUN7Y. FLA. ;
J sonville Florida n:_CORO v~RIFiED s
Pwsuant to th~ provisions of Sections 6321, 63~2, aod 6323 of the Internol Reve- ~()~w Q
nw Cod~, notice is h~r~by 9ivsn thot there hove b~en ossessed uod~r ths Internol `~0
R~venw lows of th~ United Stotes aQoinst the following-eomed ta:poyer, tox~s ~ O~J~V ( y ~ Q• Os
(includiny interest ond penoltiss) which oft~r dewond for poymeot ther~of renwin •
unpoid, and thot by virtue of tfie obov~-mentioned stotut~s th~ amount of said toxes, ~~~F~~~,LZ~
to4ethK wit6 penolties, interest, ond costs thot moy accrue in oddition tMreto, is ~
o lien in fovw of tM Unitsd Stotes upon oll propertr ond rights to property belong- fi0,.f_? r OITR..$
~n9 ~o soid toxpore~. ' CLERK L`IRCUlT COURT.
NAME OF TAXPAYER
o~r~~? v. F~?x
RESIDENCE '
3102 l..riue "Y~, Fort Pieroe~ F]oric~r.331i50
CLASS OF TAX UNPAID BALANCE
(Tax Return Foim No.) PERIOD ENDED ASSESSMENT OATE I~ENTIFYING NUMBER OF ASSESSMENT
(o) ~b ) (c ) (d ) (e ) -
I
~ lo4a? 12»3L.67 la-1o-69 266-96-5490 ~33.51
10l~0~ 12-31-68 5-9-b9 266•~9~»51a90 122.03 ~
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PLACE OF FILING Q 1'~C~ ti C
st'• ~C~ TOTAL s a55~5~
~`ti~ ~.~TO~~ ~101'1~Y .e
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WITNESS my hand ot lil~at AItL BNt3h~, ~'lOr3+dt , on this,. '
;
the~t~day of ,19 TO ;
SIGNATURE TITLE
~
Oronp ~o~psrvis~r ~
?bora C. Otava ;
(NOTE: Ce~tificot~ 04 oFfie•r o~~hort:•d br Im+ ~e rok• eekna.l.dy~•ms ~r not ~si~Miol to th~ validitr of No~ie~ d F~d~ral To~ Li~n G.CJA. ~
26~19, C.B. 19SP51, 125.) ~ '
eooK 1~4 PACE 1b~6
= PART 1-To be ~Nain~d br rocording office
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