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fam 668 oFnutr~r~t oF n~ t~?wer-+rraw?t ~r~ut sfe~ - ro? qPnwa~ U~. er R.cordr~ o~c. ~
{~v iao) IfOTKE OF l~O~AI TAX t~i INiO~ NT~NAI ~ tAWS :u ~ C Rowtrr~ ;
a~aot~onvilL, t'l~ids s~ NuMe~t ~~•I~o,~c~ rorqa~t ~
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PursuoM ro the prov"~sions of Sectia?s 6321, 63~?' and 6323 of .the Intarnai Reva-
nue Cods. notice is hareby giren Hw1 there hov~ assessed under ths Internol
Ravenus lows of the United States ogoinsi the fdlo~g-nomed tanparer, tmca (intlud- ;
inp intanxt o~d penolties) which oher denwnd for poyment tl~eof remoin unpoid. ond ;
Mwt by rirtue of the abovs-mentia~ed stahiles Hie vew~M of soid taxes, togNher with -
penahies, inte~est. Qnd costs thot moy accnrs in oddfion thereto, is a lien in favor of
th~ Uoibd S~a?es upon c1l prope~y and righh ro p~op.rryr belong~ng ro sa~d ~a~ayer. ~CJi~82
~vnME OF ~?x~?YER JO~Dt H. 3T~lQt~ ~8., ~ ~
Jahn~~• ~nto B~~
RESIDENCE 3~j U~ti~' Rd~~ P'.O• H~ 5L/
l~f~ P~~s'+0~~ Fl~.•33~t,~
UNP111D B~ALANCE
qND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT ~
(al ~ l~l kl ~ (d1 (e) ~
~ 941 9r30-?0 12~25••70 59-~1220993 951.61 .
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~ PUCE OF RUNG Ol~sTk~ C3s'Oliit COIi~'t ~
° 8t.. IAiO~ CON~t~ TOTAL s ~
~ Pi~l~O~~ 1?L~•3~1~5~ ' 3
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WITNESS my hand ot MNt hl~ B~aOby T~+Ol3+d11 , oe 1his. ~
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the dop of ~'1 , 19 -
~ SIGIVIJURE T1TlE
L (~p1ip ~1'~10Z'
THQlAS C. OBAVBB ~
~NOTE: C~M'icaN oF oRia? ouliarized by law b takt atb~owldpmenb a nof essauid b fh~ vdidd~r d TiOn LiM O.~C.~ ~
~ ~~.~9, ~.a. ,9~-S~, ~~s., ~ ~~~~i~75' .
PART 1-To b~ rNain~d b~r ncordino oAk~ .
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