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FOrtn G6a OE~AlTMENT OF i?~ iREASURY-WTEMAL REYENUE SERVKE for Op1,d10I Uft ay RKOrdng O9~ict
~REV ~-~al NOTKE Of FEDERAt TAX l~l !lNDE~ ~tNAI RFYENlJE tAWS
DISTRICT SERIAL NUMBER R~~O ApQ R~~ _
T. LUCIE CO~~y
~0
Punuant to the provisions of Scctions 63Z1, 632?, and 63?3 of the Internol Rere- R~C~R~ VFRtF+Ep ~
nue Code, notice rs hereby given thal tF~e hove been ossessed under the Interrwl ^
Revenue laws of ihe United States agcainst the folbwi~g-ndFned taxpoyer, toxes (includ~ ~ ~~7~2t~
ing interesf and penalties) whi:h ofter demund for poyment thereaf remain unpoid. and lO 3
that by virtue of the above~me~tioned statutes the omount of soid taxes, togeFher rvith i•~~ ~
penclties, interest, ond costs that moy octrue in oddtion therEto, is a lien in fwor of
the U~ited Stotes upon oll pro~ty ond tighh to propery belonging to soid toxpayer. RO~ER ~lTaA$~C -
NAME OF TAXPAYER RK CIRCUIT COUI~~''
~a R. ~ 'I~d+t R. OMttrt
RESIDENCE
~9 1j01"~1 ~!^d ~t.TN'C
~OZ'tr ~A1~Cd ~~QY'~~t
UNPAID BALANCE
KiND OF TAX TAX PERIOD ENDED ASSE$SMENT DATE IDENTIFYING NUMBER OF ASSESSAAEN7
fa1 tbl kl !d1 le)
1oi~0 12-33+-68 !a-2~•T0 liZli-34-9L91i ~t+26.95
;
PtACE Of FlIING C1A~'iC~ C~'1~.ti C~1i1'~r
3ti. IuC~ ~01iA~ TOTAL s
~Oltr n!Q'O~> ~~ls+dt
VYITNESS mr hand at ~iti riL H~~Q~i t=11'~+di , on this,
tfie-~_dop of Oistlbtr , i 9_T4
SfCPU? ~ T1TlE ,
1'~l~8 !'i. ~A~ Oii~OUt 8~IP18~7~0~!
(NOTE: c«t~i~c~ts of o+Ficer «,+1wri:.e b,, 1aw ro tak. «ru?ow~.d~n,«,K n ~a .s~.~id b+t» ,?d~d~y of Notia of r.d.ra 1mc wn G.cJN.
~bt~9, C.B. 1950-51, 1?S.)
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