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Form 668 oEOattr~AErrt oF n~ iREwuMr-IPITERrUU RFVENUE sEav~ce Fo. Oprioiai Use ey R«o.d~ng Ol6ce ~
~~v. i-~o~ NOTICE Of FEDERAL TAX 118~1 UNDER INTERNAL REYENUE LAYVS ~ ~ ~
OISTRICT SERIAL NUMBER t~~ F~~R/~
Jacksonville ~
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PurSUant to the prov~sions of Sections 6321, 6322, ond 6323 of the Inter~al Reve-
nue Code, n~tice :s hereby given that there have been assessed under the Internal
Revenue lows of the United States against the followi~?g-named taxpayer, taxes (includ-
ing interest ond penalties) which after demand for payment thereof ~emain unpaid. and
that by virtue of tlie obovementioned stotutes the amount of soid toxes, together with
penalties, interest, and costs that may acc~ue in oddition the~eto, is a lien in fovor of `
the United Stotes upon all prope:y ond rights to propery belonging to soid taxpayer_
NAME OF TAXPAYER pirate Village~ Inc. ~ a corporation
RESIDENCE 6508 Renaldo Way South
St. Petersburg, Florida
UNPAID BALANCE
K1ND OF TAX TAX PERlOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER ~ OF ASSESSMENT
(01 (bl kl ldl lel
941 09-30-71 06-19-72 59-1222885 1,382.76
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~ '?IACE OF FILING ~ '
~ Clerk, Circuit Court
~ St. Lucie County TOTAL s 1,382.76
~ Ft. Pierce, Florida 33450 -
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WITNE m hond at St. Petersbur Florida , on 1fia,
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~ 22nd of August , 19 72
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SIGNATU ~
Group Supervisor
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(NOTE: C' cate of officer outtwrized law ro take acknowledgments is nof esse~id b the validiry of Noeice of Federd Tox liee G.C.M.
26419, C.B. 1950-51, 125.j
PART 1-To b. nrah.d br ncor~din~ o~k.
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