HomeMy WebLinkAbout0233 ~ G , ~ '
po.,,, ~ ~ ' U. S. TREASURY OEPIIRTMENT -~wTEaNwy~ REVENUE SERVICE - For pp~o.d Us. Br Reco.d~.iy OH.c.
lREV.B-67) NOTtCE Oi fEDERAt TAX l1EN UNDER INT~RNAL REYENUE LANS -
DISTRICT ~ SERIAL N0. ' ~
J~CKSO~VII.I.S ~C
Pursuont to th~ provisioos of Sections 6321, 632'l, ond 6323 of th~ Interool Rsv~- ~ _
nw Cod~, notic~ is Mr~by yiv~n thot tha~~ have b~~n oss~ss~d uader the Internol
Rw~nw (ows of the Uoitad Stat~s oqoinst the~•fellowin9-named taxpay~r, tox~s ~ t >
(incluAio~ iot~rest and p~nalti~s) which oft~r dtw~nd for payn?tnt ther~of.remoin i - \ ~
unpoid. ond thot by virtw of the obow-m~ntion~d statut~s th~ omouet of said tox~s, 3
top~thp with p~natties, inte~est, ond costs thot eapr accrw in addition thereto, is ~ n~,/
o li~n in fovw of tM United Stat~s upon oll prop~rtr and rights to property belony- 7~ ~
~ny ro said roXpor•..
NAME OF TAXPAYER •
TQ~I~ ~ ARY.SSN H CO~TS
RESI~ENCE
Rovrs 3 Bax ai9 ;
F'OR? PTffitCE. FL 3345~ - ?
GLASS OF TAX UNPAIC BALANCE ;
(Tax R~turn Form No.) PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT ~
(a) (b) (c) (d) . - (s) ;
~
1 12-31-69 . ~5-15-70 264~•12-8~+82 ~2s3~.50 ;
~ ,
~ - ~
i
!
~
~ ;
i
~
~
• ~
- ; t
PLACE OF FI~ING
CL~E CII~DIr OOQRT TOTA L S Z~ 3~• SO
$T IACIB OOUI~T~g
Ft. PI~CE~ 1rL0ItI~A
WITNESS my hmd dt on this,.
rhe ~ day of Nvve~bs]r ,19 ?O
;
SIGNATURE TITLE ~
. ~ ~ CFI~ICS GRrOt~
MOTE: Nri(icot~ ol efficar ~ut1a? d br 1... ~o rok. eckr?..•t•dy~MS is rwt ~f~~Mi~l fo fM ~alidilr ef NNit~ ~f F~~eol To,~ Li~n G.CJiI.
26119, C.B. 195P51, 125.)
~~1~8 ~
~ART 1 To b~ htain~d b~? ncordin~ offic~
.
- ~ ~
~-:-c
. :