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Form 666 DfMRTMENT Of THE TitEASU~Y-lITEW/LL lEVENUE SERVECE Fu Opr~o~w+l Ure ~ Reco.dmg O~ce
~a~v ~.~o~ NOTKE Of ffDERAI TAX L~i UND~ WTERNAt REYENt~ LAVYS F ~EO ~NO tE
~ISTRICT SERIAI NUMBER ~ ~~f
OQER ?01T#~i ~
JACKSONVILI.B FLOR ~~tRK CIRCWT;~~T
Pursuont to the provisions of Sectio~s 6321, 6322, and 6323 of the IntcYnol Reve- ~Rff1EQ~~
nue Code, notice is hereby given that there have been assessed under the Interrwl j
Revenve lows of the United States ogainst fhe folbwingnamed ta~cpayer, taxes (includ- ~ I ~~F~~~j'
ing ~nterest and penolt~es) which aher demand for parment thereof remain unpaid. and
thot by virtve of the obov~mentioned statutes the amount of said taxes, together with i~~~
penolt~es, ~nterest, ond cosfs thot may acc~ue in odd+tion the~eto, is o lien in favor of
the United Stotes upon oll property and rights to property belonging ro wid toxpoyer. ~
NAME OF TAXPAYER
H~rald R 6 Doris L Blv~
RESIDENCE
1821 North Fadaral Ai~hvay
lort Piarca. Florida 33450
UNPAID BAIANCE
KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER • OF ASSESSMENT
lal Ibl k) (dl lel
~ Pittsburgh, Pa.
! 1040 Incas~ 12•31-67 06-26-70 168 22 9989 $ 3.665.37
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~ PLACE OF FIUNG
- cisrk, ci=cuic courc
St. Lucis County toTA~ S 3.665.37
= Fozt Pi~sc.~. Florida
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Er; WIiNESS my hand or West gala Bsach, llorida , a, ~,;s,
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F rh~ 12th dor of Narch , 19 71
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~ (Np1E Cert~f~tdt of ofFicer ovthorued br law to ~ak• acknowledgm~nh n nd ess~rn~ol ~o th~ vo6ddy of Nohcs of F«Mrol Tos t~en G.C.M
?6~19. C B. 1950-51, 125.) ~ R
~ PART 1-To b. r.~oi~.d br ncordin~ oAic• 600A
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