HomeMy WebLinkAbout1180 Form 668 DEMRiMFNT OF T1~ TREAAl~/-WTEWAL RfVENtlf SEIMCE for Optiorwl Ufe Sy Recwdng O~ce
~r~v ~-iol KOTKF OF fEDERAI TAX U9i UN~ MlTERNAL REYEt~ LAWS ~t ~EO ~?MO RECOR
DISTRICT SERIAL NUMBER s~. WCIE CQUN?Y
J~aksonviile rlst. AocEaro~Tp~s
REC
EO VERiF1Ep `Otlltt
Pursuant to tF~e provisions of Sections 6321, 6322, ond 6323 of the lnternal Reve-
nue Code, notice is hereby given that there have bnen assessed under the Internol ~ ~~11
Revenue lows of the United States ogain3t the fdbwing-named toxpaye~, tazes (includ- ~
i~g interest and penolties) which oRer demond for poyment thereof rcmoin unpoid: ond
that br virtue of the above~mentioned stotutes the omovnt of soid taxes, together with
penalties, interest, ond costs that may accrue in oddition thereto, is a I~en in Fovor of
the United States upon oll property and righrs ro p~ope~ry belong~Rg ro sa~d raxpayer.
NAME O~ TAXPAYER ~il.~`!!L'A ..~~~~lT~'i.~l:tL i}r~~~.z::>S~ Iid+~ .
Z O'T O~ S
RESIDENCE ^11 ~vr, 1e~,n~ F.O. f~ox l~j~
Fort pierce j Fl~.-3~IEKn
; UNPAID @ALMICE ,
KIND OF TAX TAX PERIOD ENDEQ ASSESSMENT D/?TE IDENTIFYING NUMBER OF ASSESSMENT
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; yifl ~-'1-?~ ?-?1-7°~ ;~-I'?35~~ 230.3~
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~ PlJ?CE OF FIUNG 1 e rk , G I r~~ i t C c•~ r t
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Ficsrc _ ~ r'1~ TOTAL
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WITNESS my hond at ~c+6 g t F al m:~ g C i~ ~ Fl& . , on this,
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~ the~t? day of ~~arch , 19 71
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SIGNATURE ~ T1TLE
y; sroup Supervisor
; Zhcna~ C. ~isa~n~
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(t~OTE: C.ni~car. of ot~c.r ovM?oraed br low ro ~ok• ocknowledemenK na .~al b ~h. ~o1~dy of Nntic• of F.d«d Tox l~en G.C.I~I
- 26119. C.B. 19S0-Sl, 125.)
p~~ P~ ~-To o,~. a~o~~.9i i~'~3
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