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Form 668 DEN1RiM(M OF T~ T!E/~SiJtY-YVTERIA? (QVENUE SEtV1CE Fa Oprwwl Use e. d~g OfF~e
~a~v ~-;o~ kOTKE (~f ffDERAI TAX UfN UNDER INTERNAI REYENUE UWS
'J~STRICT SERIAL NUMBER 3~ ROCf R
PQ TRAf
JACKSONVILLE FLO~tIDA c~Eak CIRCWT COY~T
- RECORO YEAIFIEO r
PursuoM to the p~ov~sions of Sect~ons 6321, 6322, and 6323 of the Internol Reve-
nue Code, nat~ce is hereby given that thcre have been assessed un.ier the internoi
Revenue faws of the Un~ted States aga~nsl the fo!lowing-nomec! toxpoyer, toxes (mdud• 213(1L~L~
ing ~nlerest pnd ~.enalt~es) wh~ch ofter demand for poyment lhereof rema~n ~npa~d. and v~0
thot by v~rtue ot the above-mentione~ statules 1he amount of w~d toxes, togethe~ w~th •,`{T=~
penoh~es, ~nterest, and cosh th~t moy accrue m addition thereto, is a hen ~n favor of "
fhe United States upon e!! property o~d rights lo property belongi~g to wid toxpoyer.
NA,1,1E Of TAXPAYER
John A. ~ Loretta Carroll
RESIDENCE
3400 Nver?ue G
Fort Pierce, Florida 33450
I:NPAlD 8ALAtVCE
KIND OF TAX TAX PER40D ENDEb ASSESSMENT DATE IDENTIFYING NUMBER Or ASSESSMENT
ta! ibt i~l (di (el
i040 Income 12-31-69 5•29-70 462 70 3486 $ 167.03
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'IACE OF FIUNG
Clerk, Circuit Court
St. Lucie County TOT~! S 167.03
, Port Pierce, Florida
VdtT1JESS my hond ot W~~~ palm Beach~ Florida ~ , o~ s~-:s,
' 27th ~r of luly ,~9 71
~~NATURE ~ TITIE V~
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C• A. St{AR!'B - - - ----A-CTINC GRWP ~UPLBVISQR ^
;t.r. i~ _~tA~cute ~l ~ikkcr ovfAar~~ed bp Ivw lo f,~1n ocknuwl~rnnnK ,s nd esvenho! lo the r~~l,d~ of Na~ce of f.d.rd f~. (wn G C M
i6ttv, t B t950-st, 195; f1 c ~
PART 1-To b~ r~lwned by r~cordin~ oR'K~ 8Q~" 2~~~'1