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Forw bbi•F U. S. T~ _ASl}RY DEPAQTMENT - IN?ERNA~ ~.EVENUE SERVICE Fw ar, f B~ R.co.d.nq pH,c•
~R~v ~~-6n MOTtCE'OF fEDERAt TAX LIEN UNDER IMTERNAL REYENUE LAWS ~ ~
OISTRICT SERIAL NO. 7: ~ ~I~~'
; .--s~.. Ct RK CIRt;
Jackeomrille~ Flol~id8 196599 B186 P289 RECORp Vr
Purs~ont to the provisions of Sections 6321, 6322, ond 6323 0( the Internal Reve- ~iFj p"'~i~..
nue Code, notice is hereby given thot there hove besn ossessed unde~ the Internol
Rsvenua lows of the United Stotes ogoinst the followin9-named toxpayer, toxes
(i~cludiny interest ond penolties) which after demond for paymenr thereof remoin _
unpaid, ond thot by virtue o( the above-mentioned stotutes the omount of soid to:es, 2~~,9~
together with penolties, intsrest, and costs thot moy occrue in oddition tF~er~to, is
o lien in fovw o( the United Stotes upon oll p?operty and rights to property belong-
ing to soid toxpoyer.
NAME OF TAXPAYER
3
AlbAr'fi at J089p~32Le g8C1CI1ey
RESIDENCE (i888 ~prp~~ S~~ ~ `
For~ Pierce, Florida 331~0
slso: P. 0. Box 62l4" oA
UNPAID BALANCE
TAX FORM NUMBER PERIOp EIVDED ASSESSAAEN7 OATE IDENTIFYING NUMBER OF ASSESSMENT
~01 fb ) (c ) (d ) (e )
MB.thholding 3/11 thru L~/66 10-13-67 59'r 5177-?0 6,?7~.64
100~ Penalty
PLACE OF FILING psrk, GYTCttlt, CQ11Tti
S`ti~ Ir11C~.9 CtyUr1~T TOTAL S 6~TTD~~i
Fort Pierce, Florida
~ NOTICE Of FEDERAL TAII LIEM REFILIN6 ~
IRS SERIAL NUMBER . _ _ _ _ _ . _ _ . _ _ _ _ RECORDfR'S IDENTIFICATlOIJ NO.
NOTICE FIiED WITH (~'],e2+j[~-a~rr-1+11Cf+6-L~OLtA~?3/'y-~~CjS - - - DATE
UXPAYER'S ADDRE~31_._$gmg_ . - - - - - -
ent fhan shown above)
SIGNATURE _ - --"1--- - - TITLE CLl~~y ~fiCB-~t'~gC~l - -
+ _ 2.
WITNESS my hand ot WBSt PB~m ~eaeh__
-T ~aQ2'1~--- - - _ - - - , on this,
the ~4t'h~day of. _ -J~ . _ 19 ~Q~ _
SIGNATURE _ - - - - - TITIE - Qr2~0Up S1]~61'STlSOr
\
(NOTE: Certificate of oflice~ outhorized by law to take acknowledgments is no1 essential to the ~alidity of Notice of Federal Tox licn
G.C.M. 26419, C.B. 1950-1, 125.)
88
PART 1-To be retained by recording office B~~x~~ ~~E~~~
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