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HomeMy WebLinkAbout0049 _ . . Gh~ _ FwA bfa'-f U. S. TREASURY UEPARTAIGNT • INtERNAI aEvE?~UE SERVICE Fw ON~ow~i us.8p R~cord~ OH~c. - (REV. 12-bn NOTiCE OF fEDERAI TAX IIEN UNDER INTERNAI REYEMUE LAwS . - ~ ~,ST~,~ SERiAI Q ~ tu~o ~ ~ J+?aksonvill~~ Fl~o~"lals 1~5780 B-185 P-2113 5.~e{~OUN ~ F]o VERIF~ED Pursuant to th~ provisions of $ections d321, 6322, and 6323 oF the Int~rnci R~v~- p~C~Ro nu~ Code, ~otics is hsreby given thot ther~ hov bt~n oss~ss~d und~r the (nt~rnol ~ Rsvenue lows o( the United States ogoinst th• following-nomed toxpoy~., !sxes 1984 e=:~ (inclvding inarost nnd penohiss) which ofter dsmond fo~ poyment thereof r~moir~ ~ ~ ~ unpoid, ond thot by virtve o( the obove-mentiontd stotut~s the amount of soid taxes, ~~o~ to9eth~r with p~nolties, interest, ond costs thot moy occrue in odd~tion ther~to, is a li~n in (ovw of the United Stotes upon oll property ond rights to p.operty b.io~s- RoGER P01TK~?S inq to soid toxpoyer. a~( C~R,CV~ C~ NAME OF TAXPAYER - Ra~r~wnd D. 1Gog~r R SIDENC 3~ 3. ~3th _ 3t~et Fort Pi~ac+o~~ lrlori+d~ UNPA10 BALANCE • TAX FORM NUMBER PERIOD ENDED ASSESSMENT DATE IDENTIFYING Nl3MBER OF ASSESSMENT (0) ~bl (c) ld) (e) - lolao 12-31-62 7-i5-64 408-~4-o3TT #~9~•07 i ~ ~ ~ ~ ~ PLACE OF FILING `.~t ~ St.~ I~~~ C0111~ TOTAI s ~~OT ~O~I'tr ~~rC~~ ~Ol'~di NOTICE Of fEDERAI TAX LIEN REFILIN6 ~ IRS SERIAt NUMBER 59"~_. _ _ RKORDER'S IDENTIFIUTION NO. ~jT~ ~ P~~rO~~ ~Ors+di NOTICE FIIE~ WITH ~~t! .~~`1 SL!_ "_'~"t~1 I DATE 8''~5~~ ~ _ fi TAXPAYER'S ADD _ _ _ _ - ~ ~ e~enf Mwn shown above? SIGNA ~ : . _ TITIE _ g~0'~~ ~ !'~~sOS' wITNESS hand at _ ~_.Pi~~~_ nQl3dt--- . - . - - - - - , on this, rhe~_---~day of---!~~-. _ 19_~_ • SIGNATURE _ _ _ _ _ TIT1E - : ~ Ci • ~Q~i ~ .~~~1~ (NOTE: Certi}icaf~ o/ offiter outho~i:ed br low b take acknowl~dymeets is nof ~sse:+liol to th~ validitp of Nofice of Fcde~al Tox lien G.C.M. 26~19, C.6. 1930-1, 125.) ao~~ 1~7 ~ ~9 PART 1-To b~ r~tain~d by recording ~ffit~