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Form 668 oEnurr~M ~ n+e tttwsue+r-x+r~aut ~vEr+~~ s~e~cE For op~ond tb. ~ R.oo.~np Ol~c.
~REV i-~o) NOTI~ Oi FEDERAL TAX td11NlOQ NtBIlAL REVENIlE LAWS AN RECOR EO
t . ~uciE couNTr
a~~ ~ N~~ C~E KcC1~iCUIT COURT
Jaokaonvllls P`lo~ids 11ECOR9 YERIFtEO ~
Purs~wnt to the provisions of Seclions 6321, 632l, and 6323 of ths Inte~nol Reva fE~ ~ 10 s6 AM ~t'
nus Code. notice is herebp given thct there have bee~ ossasssd w~der the Intereal
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R~venue laws of the United States ogoinst the fdbwin9-nomsd taxpoyu, toxes (ir?clud- ~ ~
ine imKest ond penolties) whith after demand for po~teiaM tl~eof remain unpoid. w~d ~
Mwt by virtue of the abovamemioned statuMs the amount of soid ioxes. togeiF~ with - ~
p~altia, inlerest, ond coais that moy accrue in oddtion there~o, is a lien in fawr of fi
~he Unired Staes upa+ a11 propery and righ?s ro properfy belong~~ b~. 2C419~~ ~
NMAE OF UXPAYER ' ;
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RESIDEPICE
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Fort Pieros l~loarida
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qNp OF TAX UX PERIOD ENDED ASSESSMEM OATE IDENTIFYING NUMBER OF ASSESSMENT
(aI (b) (d) ~°1 ~ -
941 12-31~9 3 3?-?0 oG-~o656049 ~479.50 ~
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SIGNATi~E ~ ?1T[E AC?IIiG
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