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Form 668 DESARiMENT OF THE TlEASUQY-INTERN/?t REVENUE SERVKE For Ophoral Ust ~ Record OR'~n
~REV. i-io~ NOTKE Of fEDNtAI TAX t~l UND~ MITQtNA! REYENUE UWS SZ,~~CIE COUNTY
DISTRICT SERIAL NUMBER ROCER POITRA=
Jackaonville Florldo CIERK C~RCUI'! CQYRT~
RECORO VERIFIED..r.~..~
Pursuant to the provisions of Sections 6321, 6322, and 6323 of the Internal Reve- pv
nue Code, notice is hereby given that there hove been assessed under the Internal ~11
Revenue lows of the United Stotes aga~nst the folbwing-named taxpayer, taxes (includ-
ing interest and penolties) which oher demand fo~ payment thereof remain unpoid. and
that by virtue of the above-mentioned statutes the amount of said taxes, together wiM ~r~
penakies, interest, and costs lhat moy accrue in oddfion thereto, is o lien in favor of IGr.i~~
the United States upon oll propery and rights to property belonging to soid toxpaye+. .
NAME OF TAXPAYER -
TARL C~ARlQN, JR.
Earla 3ervics Station
2ESIDENCE
5001 3. Fed~eral HMy.,
Fort Pierce, Floridr3345~
UNPAtD BALANCE
KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
lal lbl kl tdl f~l '
I 9l11 12-31-?0 6-4-71 59-1163454 424.77
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~ PUCE OF FIIING C],e~C~ C~I'C1l~t. riOUtti
~ 3t. Lucie Count~ TOTAL = l~21~.77
~ Ft• Pierce~ P'la.
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~ WITNESS my hond at ~Iist Pils B~iCh,s F'l+~l'1da , on this,
~
~ rhe ~_dop of~ t , 19 71 8_'R ~ O~"
SIGNATURE ^ . T1TlE
~"l'! aroup Sup~r~ipr
Thomas C. Graves
(NOTE: CertiFcde d oA'icw ovMarized br taw b tak~ ocknowi~dpm~nb is nof ~enfia! b fh~ volidily of No1iu d Frd~rd Tox l~n G.C.M
26119, C.B. 1950-51, 1~5.)
PART 1-To b~ rMain~d b~r ncord'ino oAlu
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