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Form 668 oer~er+~~r oF n+e n~w5un--rrre~r+~u e~~ue se~ , rw op~ond u,. ~y [Kn.dn~p olFc.
~~v i-~o) li0T1CE OF ffDERAI TAX LlBI UNDH ~tMAI ItEYENtlE tA1Nt
DiSTRICT SERIAL NUIKSER i11.L~ wfl Y
JACx90NVIIJ~S sT. ~
R POtTR~
Pursuant to the provisioru of Sections 6321, 6322, and 6323 of the Inte.no! Rsve~ ~ECOR9 YER
f~tEO~
nue Code, notice is hereby g~ven thot there hove beeo ossessed undef thc tnlernol
R~wenue laws of the United States ogoinst the following-nomed taxpoyer. toxes (;nclud- ~ 9 3~~~~Z
ir~ interest and penalties) which ofter demond for payment thereof remain unppid. ond
thot by.virtue of the obove-mentioned statutes the amount of wid toxes, together wish
penalt~es, interest, and costs that may accrue in addition thereto, is a iien in favor of
the United States upon ol! property ond rights to property belonging to said taxpay~er. ~~NR~/a~Fr1~+4
NAME OF TAXPAYER
Gene A~ EVe],jm C. Davia
kESIDENCE lc~ yo!'k C0112`'~
Ft. Fierce, Fl. 33'45~ ~
UNPAID BAIANCE
K1ND OF TAX TAX ?ERIOD ENDED ASSESSMENT DATE 1DEt~(TIFYING NUMBER OF ASSESSMENT
lal (b) kl ldl 1~1
; 1Q44 1,2-31_70 5-28-71 26?_62-7107 596.25
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~ PUCE OF FILING
3 qertc, Circutt Court TOTAI t 596.25
~ SL Lucte Counry I -
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~ Fort Pteroe. Flortds
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~ WITNESS my hond ot ~ on this, .
- tt,e ?th ~r of i+Sarch , 19 72
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_ SIGNATURE TfTLE
' i ~ ~tice Branch
~ (NOTE: Certificale of of1'icer oofhwized by low to toke acl~nowledgments is not asenfid b tfis volidAy of Nofice of Federd Tox lien G.C.M.
~6419, C.B. 1950-51, 125.) Q ~ ~
PART 1-To b~ ntointd br rocordin~ of~ic~ $C~K
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