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FOrm G6S OEPAtTMENT OF TME IREASUK-NTEWAI REVENUE SERVKE For Opfiorql Ufe BY R~cwdng OI6c~
~r~v. ~-io~ NOT{tf OF FEDERAI TAX UQ! UNDBt WTERNAL REYENI~ UMIS ~
~ISTRICT SERIAL NUMBER ~',E~ p9t;~ ~ .
J ~'l~a~ida q.~ ~:~c.wT ~a~'~ ~
~L~ 1~ER~.~B~...~~.
Pursuant to the rovisions of Sections 6321, 6322, and 6323 of the In~ernol Rev~
nue Code, r.otice ~s hereby given that there have been auessed under the Internal
P IMt i5 3 ~~I'72
Revenue laws of the United States ogainst the following-narned taxpayer, toxes (includ-
ing interest und penalties) which aher demond for payment thereof remoin unpoid. ond -
that by vi~tue of the above-mentioned statutes the omount of said taxes, together with M~~
penalties, interest, und costs ~hat may occrue i~ oddition thereto, is a lien iri favor of ~
tfie United States upon oll properry ond righh to propery belonging to said toxpayer. -
h1AME OF TAXPAYER
~IItST PROC~'fSIlA 1~0I~P0AATT0~I
RESIDENCE
P. 0• B oac ~3lt
9iro Hea~o~ ~lorids 329~60
UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDED ASSESSMENT UATE IDENTIFlfING NUMBBt OF ASSESSAAENT
(al (bl l~l ~d~
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Wl7NESS my hond at id~wt Pa]~ Beaeh~ *'l.R•t~ . on fha,
the ~_day of 1"~~ , 19~
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i:; SIGNATURE m~ '
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(NOTE: Cert~cde of of&er avthoraed by low ro take acfcrwwfedgm~nh is na1 e~sdid b tM vdid~ of Nolia oF f~dad Tmc lier? G.CJrI
26419, C.B. 1950-S1, 125.)
PART 1-To b~ rMain~d Iry nwrdinp oAk~
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