HomeMy WebLinkAbout1662 F~ i6t U. S. TREASIJitY OEPARTIIElIT • bl~ERNAI RE~?EMUE SERVICf~ Fr 4ee~1 i!r Aj A~errJ+~ Offic+
t R E V.~.e» NOTItE Of fEpERAI T~l L~11 lIN6~ INTERN~I RErEMdE IANS ~ pQpj. } ~
DISTRICT S~R1Al N. " F~~~~ANO RECOR
J4C6~0 1~Tr0iBIDiA ~ S?. l.UC1E COUNTY.
` . R~~RO VERIFIED
Paswnt to tM o?ovisia~s e1 S~cfia+s 6321; 6 t on~ 63~3 ef th~ MtKw~l R~w- -
mM C~, notin is Mr~br ~iwe thet 1Mn hov~~w esstss~d w~d~~ th~~'int~nwl 2 .
R~~~y~- b«s of tl~ Unit~d Ste»s a9einst 1M iollwin~-nawed 1a:po~t,-tax~s q~ ~ 10 + 5Z
( i n c l u i i n~ i e h n s t e n d ~ e a l t i~ a l w
fi
i c
h ~ h N d~
i n~ E o r p o y~ n t t M n o i n A e i n ~ O ~ L.
~nM~,,, •nd ~het br vi?tw of ~M obow-~tion~d st~fuNs tM e~ount of sai~ ~ex~s, '
tey~ll~r ~rith ~nohi~s. int~nst, ond costs ~het w~r ~ccrw ie edditiow t1~r~M, is ~
~ li~n in ia~w of,tM lh~ited Stot~s upon oll prop~et~r end ri9hts to popKtY b~looo- ROGEa P0ITRAS
00
~9 ts ~so~1 texporir. ~ . _ r,1~AK CIRCWT COUHT~
NAME OFaTAXPAYER
~T~• ~~a• ~i~ _ . _ .
RESiDENCE ' . ~ - . ~
~tl. 4~ HaZ 26~~ 1~01_t Pi~r'Cei ~14rid~33450
~ _
CLASS OF TAX . c- ~ ~ . UNPAID BALANCE
tTox R~turn Form No.) PERIOD ENDED ASSESSMENT OATE IDENTIFYING NUMBER OF. ASSESSNENT _
. (a1 lb? (c) (d) ~
lAltO 12•31"b9 V~~74 28lj~10~369j +~7v~29
~I
i _
i - . .
f . .
~ .
, . - -
~ !
. ~
.
. ~
_ ~ - • t
E
~ s
j
~
3
~ ~
PLACE OF FILING Cl+~rk~ C~t. COlli'tr •
I~yiti~ G01ID~ TOTAL f ].QB~~
T~ P'1~YO~~ FLO~i~L ~
wITNESS my hand m Y~st~=.~~- , a+ tbis,.
th. lT±h do~? of .19 ~ , - .
SIGNATURE TiTIE- . , . .
~ ~ !stt~ t~ap s~pse~.ao~r
~ Cr.ti/1eN~ ~t e11ic~ wrthwl~ ?p N~~ekwwl~ts is w~t Ns~efiN h tlM ~Ii~N~r ~i qrin ~f f~/~rM Tr ~1«? G.C~(.
1!. C.~. 19S~sf. i2S.1 ~ - .
rARt i~. b. ~.~oiw.~ b~r ~c~n/.Hk. RO~c~V~ I~iGf ~U~
~ _ _ _ _ _ _ _
-