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Form 66e U S TREASURY DEPARTMENT • ttatE~tv~~ oCvrr._t 5E=: KE I r-. ^f. ~se
a.,- j- iit~iiiE 0~ FEDE~C~t TAX ti~li uMD~R i~iiERiiAt ic~YEiiU~ tAi~ii
~iSTRICT SERIA~ NO. F~ D ANDfA ISEO~
Jwp~gppy~,g ST. U CIE CO~NTY: i~l'A: ~
PursuoRr to rhe p~ovis~onc of Sec+~ons 6321, 63??, o.+d 6:i23 nf t1+• ~..,..~oi R~~~_ ECORD V~RIf!EO
nue Code notice ~s herebv o~ven that thero hove Men ossessed ~~der the Inrernol ~ '1~~~
Revsnut lows of the Un~ted Stote~ ogoinst the Following-nomed !oxpayer, toxes
(includinq ~nterest and penolt~es) wh~ch ofter demond for poyment theieof re.~i~ T Z ~ ss
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unpaid, and that by v~rtue of tnc obove-me~t~oned statutes the omaunt of so~d taxes,
:oyethse ,.;~h penolf~ss. ~~~terest, ond costs thot mo~r occrue ~n odd~t~~~ there~o, ~s
o I~~n in fovor oF the U~~~ed $tc~es upon all property and r~ghts to p~ocK.~,~ b~to~9- OGER POtTRAS ~L
`"9 :°`d '°xp°Y°`. - K CIRCUIT COURT~
NAME OF TAXPAYER
J~I~l~ W~ ~I.ICE JQNS GNTRSLL
RESI~ENCE
RT 2 BOS 1113
~O~tT PIffitCE. FL 33~+54 -
CLASS OF TAX UNPAID BAIANCE
Tox Return Forn, No.) PERIOD ENDED ASSESSMENT DATE lDENTIFYING NUMBER OF ASSESSMENT
;u ) (b ) (c ) (d ) (e )
1040 I2-31 21 7 2~46-7~+22 1, 061.45
` idW 12-31-65 0~•15-66 262~6-7422 y08.41
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PLACE OF F{LING
CI.~i[ CIACOIT CO~tT TOTAI Sls~g•86
~ ST LIICIB OOIIN1?
~ !7. PI~tCS. 1rL
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WITNESS mY hand ot ZBJ~~ 1~I~ORI~I , on this,
the doy of $eQt.rbe~' ,19 ~
SIGNATURE TITLE
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MOTf: G.?~F;we~ o( o~(~c~. ov~Eo~~i ~k!''~c1.,o~l~dynNnts is not ~s~~m~el ro ~M vol~dc~~ ~No~~u d Fed~~ol To¦ L~en G.C.M-
26119, C.B. 195P51. 115.) ~ ~0~~~
PART 1-To b~ r~fain~d br r~tording offit•
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