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~~v taoi MOTi~ OF ~fDdtAl TAX llNi 1lMDB ~lTBtNAt lEYENI~ lANls p
DISTRICT SERiAt Ni1AABER. Sf r~D~•4~Y~
JACIKSOliVILIE lfABIDA ROOER P011RAS
CLERi~ pRCWT C
Pursuo~ to the provisiora of Sections 6321, 6322, and 6323 of the Internal Reve- ~ECORD yERtF1E0
nue Code, notioe is hereby given M~ot N~ere hw~e besn assessed under the Internol ,
Revenue lows of the United States agains~ the following-rwrned taxpoyer, toxes (includ- ~ (Z ~~~~Z i
i interest ond lties whith aker demand for ?
ng peno ) paymant theteof remoin unpaid. a~d s
that by virtve of the abovementioned statutes the omounf of said taxes, ~ogefher with ~
perwhies, interest, end cosfs that may atcrve in addtion the~eto, is a Gen in fwor of ~
the UniMd States upon oll properfy and rights to property belonging b said~t~a~ayer. :
NAME OF TAXPAYet
RESIDENCE -
Ya~t~ 3, . Doac S10
4
ur~rao e~a~wcE
KIND OF TAX UX PERIOD END~ - ASSESSMENT DATE tDENTIFYtNG NUMBER OF ASSESSMENT
~a) ro~ ~dI (e)
t
,
1040 Iacorae 12•31-70 4S-L4-71 086 30 7185 $ 61~.81
i
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PUCE Of FIUNf3
Clerk, Circnit Court 70TA1 : 614.81
saiat Ltda Couut~
!ort Msre~. l~lorida
WITNESS nry hand at itatt PiL ~cL. tlorid~ , on Ihis,
~ _ZttL_dop of ril . 19 22
TITLE
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(NOT6 CIr1i~,a1~ of.aAioer ouMarir~d by fow b rak~ acknawl~dpmsMs a nof ~id b tl~ valid~ry of Noties oi fvdrrd Tmc li~n (3.C.A~
~br19, C.a. 1950-51, 145:) ~ ~
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