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Form 668 DEtAR1wtEM OF THE TtEAStle~t-r+TEa1~l RfYENUE SEMCf ~
(REV. 1-70~ NOTI~ Of EEDERAL TAX l~l UNO~ MITBtNAI REYEMUE LAwS IUCIE COUMTYRfIA. ~
DISfRICT SERIAL NUMBER ROCER POITRAf =
CLERK CIRCUIT QOUIIT ~
JACKSONIIILI.S, FL~IDA IIECOR~ YERIFIEO....~~ ~
Pursuant to the provisions of Sect+ons 6321, 632Z, and 6323 of the Insernot Rev~ ~
nue Code. notice is hereby given that there hwe b~en assessed under the Inter~al fEe " ! lT 1~ a
Revenue laws of the United States agoinst the fdbwit~g-nomed toxpoper, ~axes (~nd~d- ~
ing intKest ond penalties~ which oRer demond for po~nnent fhereof remain unpcid. and 2Q45 ~
Nwt bp viriue of the obovo-mentioned stotutes the amount of soid taxes, bgether with 1~
panahies, interest, and costs that moy occrue ie adfiition thereto, is a lien in fovor of
ths United Stores upon oll propert~r ond rights ro propert~? be~w~9~ng ro said ro~oyer. '~~D
NMAE OF TAXPAYER
Laalis A Childs
C~ H Auto xe air Service
RFSI~ENCE
2511 Okeechobee Road '
Fort Pierce, Florida 33450
UNPAI~ BALANCE
KINO OF TiVC TAX PERIOD ENOEp ASSESSMENT DATE IDENTIFYWG NUINBER OF ASSESSMENT
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~ 941 withholding 09-30-7~ 12-25-70 59-09~6783 $ 648.b1
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~ PIACE OF FIUNG ~
~'y Clerk, Circuit Court TOTAI s 698.61 ~
~t. Lucie County
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Fort Pierce, Florida :
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~ wtR+JESS nry hond ot West Palm Beach, Florida , on ~his, ~
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M+s 9 th FebsuatS? , 19 ~ i ~
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?HO!!AS C. GRAYES GROUP SUPS~tVISOR #
~ (NOTE: C~f~ficde d o(Rcr ouNar~ud by law 1o tak~ «luwwldpmanb ~s not wawid ~o Nr vaGd~? of No1ia af fid~rd Tm~ ti~r? G.CJYI ~
26~19. C.d. 19S0-Sl, 125.) '
- PAItT t-To b~ ntai~.d bp hco.din~ oA1a 60GIf ~Vi1 ~fbt!
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