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HomeMy WebLinkAbout0965 Forw 66{-f U. 5. TREASl1RY DEPARTAAENT - iNtERa~~ REVENUE SERV~CE for Op,onol Us~ Br Reco.I~ny ON~c~ ~R~v. ~2-e~ NO11CE OF FEDERAI TAX IIEN UNQER INTERNAI REIIENUE LAwS f~~EO +?x DISTRICT SE R IA L NO. • ~T• L11C~E COUN Y 136677 B-120 P-519 lIOCER PO~1RA: t~rn~rr~ c:a: s: ~t. c~EaK ciRCwt eo~ Pursuont to th~ provisions of Sections 6321, 6322, and 6323 0( the Internal Reve- RECOfIO YEa~F1EO~- nw Cad~, notic~ is hereby yiven ~hat there hov~ be~~ ossess~d und~r ths I~tsrnol ~~O ~ O~ Revenue lows of the United States ogoi~st the following•nomed toxpayer, toxes (including interest and penolties) which ufter demond (or poyment thereof remoin unpoid, ond thot by virtue oI the obove-mtntionsd stotut~s the omovnt of soid toxes, ~ 0~ Q~ 9 top~tfier with psnalties, intsrest, and costs thot moy occ~us in odditio~ ther~to, is V~ o lien in (ovor of ths United Stotes upon oll propsrty ond rights to property belong- n iny to soid to:poyer. f! yAME OF TAXPAYER C6arles M Amo R ESIDENCE Z6Z ~i i~l=y ZdAt PaL Baich, Florida UNPAID BALANCE TAX FORM NUMBER PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT Io 1 (b 1 (c I (d ) (e ) ~ ~ ~ ! ~iF~ 4-58 5-7•6S OS/65/290000 ~ 9,656.31 ~ ~ ~ i ~ 4 ~ € ~ ~ PLACE OF FILING ~ Clark, Citcuit Court aa~ TOTAI s • 9,656.31 ~ _ ~ost lirae~ .~Tl~rLi~- ~ NOTICE Of FEDERAL TAX LIEN REf ILIN6 ~ ~ IRS SERIAI NUMBER _ S9•OS _ _ _ _ _ RKORDER'S IDENTIFICATION NO. _ . ~ ~ ~ Ha~~ l~Ott~a - ~ NpTICE FILED WITIi~~~x'k•C1lC~11t CONlt~ Si~ ~~rr I. DATE ~~7~ ~ a ~ TAXP/1YER'S AD S $07~?s~. _Paln_ Beach,._Florida 33~80 ' - - - - - ~ ~ ~ - (If di rtn n shown obore) = ~ SIGNATURE _ TITIE ~~P ~~r~ ~ll~ction Div. ' i~ - - - - y - - ~s - - ~ ~ ~ WITNESS my hond ot i?O CMt=CL 8~st~ Nsw Yosk _Cit~~ tiw/ Yotk - , on this, - - - r~ s~ rhe---~~_-daY --'ft1M - - - 19_6S - - ~ ~ ~ SIGNATURE _ ~riN _A_ _~r~ _ _ TITIE _ _ D1ft1'~Ct D YtCtO= - ~3 . ~5 i;.• . _ _ . _ . . _ . . . . . _ _ . . ~ ~ ;NOTE: Certificate of officer authorized by low to take acknowledyments is not tssential to 1F?e validify ol Notice o4 ~tral Taa LiM n" G C.M. 26~19, C.6. 1950-1, 125.) • ~ ' l9~ 9l~ . PART 1-To be r~lained br recording offic~ t_~ C: }iz'c >y~. SGD4~ - ~ ~ _ _ _ s_