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Form 66S DEPIIRTMEM Of TME 1AEASURY-N1EWAl REVENUE SERVICE For ~pf~ U~e Ar R~owd~ng OlFn ~
~~v. i-~o~ NOTKE Of ~EDERAL TAX L~l1 UND~ MITBtNAI REYENUE LAWS sr. ~uc,~ couNnr ~
DlSTRICT SERIAL NUINBER ~
C~E~CtHCWT ~ApjMT ~
Jacksonville RECORD vER~F1E0~„~~,~„
Pursuant to the provisions of Sections 6321, 6322, ond 6323 of the Internal Revo- ~
nue Code, notice is hereby given that tfiere have been assessed under the Internal T,
Reve~ue faws of the United States against the fdlowing-named taxparer, taxes (includ-
ing intemst and penalties) which afMr demand for porment N~ereof ~emain unpaid. and
that by virlue of 1he abovamentioned statutes ihe omount of said taxes, togMher with
penahies, in~est, and cosls thot may accrue in addition thereto, is a lien in favor of
the Unilad Stotes upon all propery and righh ro properh? belonging ro said ro~ayer-
NAME OF UXPAYHt
i-_orace S:,eetin_-
RESIOENCE 81j l~tii :;t.
~~t. Fierce, 1'1 334~~J
UNPAID BJILANCE -
KIND OF TAX TAX PERlOD ENDED ASSESSMENT ~ATE IDENTIFYING'NUM66t OF ASSESSMENT
~a~ ro~ <<~ ~d~ ~e~
i ~.tr~.. , L 1~~(~ /l^~.~)~~' 2~5~1~CJ~~~ V5 1 1l~1~t~ j'i
I _1"~J ~~3~.~~j •~t'1'~~~7~ "
; 12_~1-Fx'~ ~+'-~9-?1 107.22
~
; _`-i'J ~~~L~S Y~~~~7~ " ~~`i1
~ , 1.2_31_G7 ?4_02..71 611.72
~ L~~o Z~31_?~ ~5-07_71 6q5.36
~
~
, .
~ PLA~E OF FIUNG °ri: ~'ircuit :;ourt
. _ .
~L. il?C1@ COU2l~~
~ .-~ort t
ierce, :~a. TOTAL s 45~3•29
~
WITNESS my hond at -~iaali ~_1a. , on Ihis, ,
~
the ~ day of ::ept. , ~ 9 71
SIGNATURE TITLE ~(IOK ~
. , ~ ~hief, Uffice :sranch
(NOTE: Cat~Ficate of off~ authw to toke acknowlsdgmsnh ~s no+ esseot~d ro rhs ~ot~diy of Nor~ce of Federol Tax l~en G.C.M.
26I19. ~.B. 1950-51, 125.)
PART 1-To be rNaned by r~cordinp oRk~
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