HomeMy WebLinkAbout0967 Fonn 66H OE?AtTMENT Of TFE iREASIAY-MITE#~IK lEVENUE SERVKE Fa? Opliorld Uft ey R QR'it~
~rr~v ~ao~ NOTKE OF ~OBtAI TAX L~! UNDQ MIT~NAt REYENUE LAWS f~~ ~
sT. ~E co
D~STRICT SERUL NUMBER ~pQ~p POltUA=
Jack~onville l~lorida CLERK CIRC~tT OOY*T ,
RECORO yERtf1E0~---
Pursuont ro the provisions of Sections 6321, 63Y1, aRd 6323 of the Internol Reve- ~ ~
nue Code, notice is hereby give~ fhat there have beert ossessed under the Inter~al ~
Revenue laws of the United Stotes ogainst the folbvringnomed tazpayer, toxes (includ-
ing interest ond pe~olties) which ofter demand for poyment thereof remoin unpoid. and
thot by virtve of the obove-mentioned statutes the omouM of said taxes, together with Q
penolties, interesf, and costs that may accrue in addition thereto, is a lien in favor of V~~ ~
the Uniied Stotes upon all property ond righh to property belonging to said taxpayer. ~
NAME OF TAXPAYER
Ja~ss L. And~sraun ~
RESIDENCE
Sa~~s, ~psrtwat 5s North 0. S• 1
l~orti Pi~ro~ 1r3.orLL
UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDEMIFYING NUMBER OF ASSESSMENT
(al ibl k1 ld1 kl
1040 1Z-31-69 5-29-7~ 482-2b•4T13 ~420.21
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` PLACE OF FILING CleTk~ CilCUltr COt1Z`tr (~20•21
$t. LtL01~ COt3A~ TOTAL ;
4$ FOY't Pier'C~, 1r'3~0l1~di
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WITNESS my hond ot ~at Pa3i B~aoh. Fl~or'ida , on th~s,
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;z the 26th doy of N~?~'Cf1 , 19
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TIiQ+il13 C. tSiJ19&~ (~fiOUP SUP~tVI3t~
(NOTE: Certd'icde of o11'icer ou~Fwraed by law ro take acknowledgmenri is nd essentid ro fhe voGdily of d Tox L~1.
26419, C.B. 1950-51, 1~5.) d~~ ~Jl) :
~ PART 1-To b~ ntai~d bY ncordin~ olBc~
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