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Fonn 668 U. S. TREASURY DEPARTMENT - INTERNAI REVENUE SERVICE Fo.Ope~oe~1 us. er R«o.d~.~y OH~c.
(REV. 8-67) NOTItE Oi FEGERAL TAX LIEN UNpER INTERMAL REYENUE tAWS F~LED aNp RECORDEQ~ ~
DISTRICT SERIAL NO.
ST, LUC1~ COUNTY. ~LA:
Jaelcaonvills l~'L, RECOR~ VE~71FtED ,
Pursuont to the provisions of Sections 6321, 6322, ond 6323 of the Inte~na) Rev~- ?(~~A~
nue Code, ~otice is hereby given that ther~ hov be~n ossessed under the Internol .
Revenue lows of the United States ogoinst the following-nomed taxparer, taxss Au • q '
(including interesf and per?olties) which ofte? d~aand for poymenf ther~of remoin 70 ~Y Z 1 iY'1 L~ -
unpoid, ond that by virtue of the above-mentioned stotutss the amount of soid ~oxes,
topet6~r with penalties, intersst, ond costs thot way occrue in oadition thsreto, is
o lien in fovw of the United Stotes upon all property ond ri9hts to property belong- ~~v~a~~A
ing ~o so~d ro:Poye?. CLERK CiRCUIT COURT:
NAME OF TAXPAYER ,
FBA1~ a00D, QLosast~er Si~n
RESIDENCE
P.O. B~z 582, ~t. Pierce~ P'la.•33450
CLASS OF TAX UNPAID BALANCE ~
(Tox Return Form No.) PERIOD ENOED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
(o) ' (b) fc) (d) (e)
! 9l~1 - 9-30-~ 12~3-~ 59-1105298 821.03
_ ;
PLACE OF FIUNG ~
~ St. Lncie O~nat~
Ft. ~S~e' TOTAL S 8Z~Q3 i
~ M1! TN ESS my hand ot 1~i~st Pil~ HAtOtis ~1"~ , on thi s. ~
~ ~
~
~ the},Qf~day of Ka/ ,19 ?0
~
~ SIGNATURE TITLE
~ ' oro~p ~.r~rlao: ~
itian~ C. Qsa~ru f
~ (NOTE: Grrificon o( of(;c•r ourh«i:•d br low ~o tok• ockno.»I•dq~w•nrs is net ~as~ntiol to tiw •oliditp o! Ndic~ ef F~dKal To~c Li~n G.CJiA.
~ Z6119, C.B. 195P51. 125.) ~
~ 2176
PART 1-To be ntained br recording offic~
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