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Fw~ 668-F ~ U. S. TREASl1RY OEPARTMENT - ~HtERNAI REVEHUE SERvtCE n o1 Us~ e Rec«d~.g OFl~c•
~REV. 12-67) NOTICE OF FEDERAI TAX LIEN UNDER IMTERNAL REYENUE LAwS St.lUC1E COUNTY~FLA.
DISTRICT SERIAL NO. ROCER POtTRAS
JACKSONVILLE~ FLORIDA 265827 8172 Pb68 CIERK CIRCUIT COURT
RFCQRD V£RIF1E0~.,~
Pursuont to the provisians of Sections 6321, 6322, ond 6323 oi the Internol Reve-
nus Code, notice is hereby given that there hove been assessed under the Intsrnol 8
Rsvenue laws of the United Stotes o oinst the ~ollowin nomed tox v
9 9' paYer, toxes
(including i~tsrest or,d penalties) which ofter demond for poyment thereof remoin
unpoid, ond thot by virtue of the cbove-mentioned stotutes the omount of said toxes, ~j~M~Co~
topether with penaltias, interest, ond costs tl~ot muy occrue in oddition thereto, is ~r <<•~
a lien in favor of the United Stotes upon oll property ond rights to property belong-
ing to scid taxpoyer.
NAME OF TAXPAYER
I~I(~GINS 1'IRE SUPPLY, INC.
RESIDENCE
1312 Delaware Avenue
Fort Pierce, Florida 33450 '
UNPAID BALANCE
TAX FORM NUMBER P~RIOD ENDEU ASSESSMENT DATE IDENTIFYIfVG NUMBER OF ASSESSMEN7
~a) (b) (c) (d) (e)
941 YVithholding 9-30-6? 22-1-67 59-0968482 S 928.20
PLACE OF FILMG
C~erk, .Circuit Court
St. ~ucie County TOTAL s 928.20
Fort Pierce, Florida
NOTICE QF fEDERAI TAX LIEN REFILIN6
IRS SERIAL NUMBER _ _ _ _ 'rJ~OJ _ _ _ . _ RECORDER'S IDENTIFICATtON NO.
Clerk, Circuit Court
NOTICE FILED WITH ~L ldl~ie Countv
+_~f_~jgT~Py FIQTida- - _ _ DA7E _ _
TAXPAYER'S D ESS
If differenl thon shown obove) _ ,
SIGNATUR ~ ~ _ _ TITIE ~TQlI~? S1~B~'V~&O~.* _ CAI~ ~S/~S30I1
omas . ave
wiTNF55 my hond ar ~~est Palm_ Beac~ F],Q~~_ , on rhis,
~he _ 28th_ -day of 1i83TCh 19G$ _ A :
, s ~iTYw ~V ~1~[
SiGNATURE _.A. J. U~ Lbnnell, Jr. _ . nnE _pi~trict_pirector
jNOTE: Certificate of officer authorized by fow fo take acknowledgments is not essential to ~he volidi?y of Notlce of Federol Tox lien
G.C.M. ?6419, C.B. 1950-1, 125.) 88
PART i-To be retained br recording offite
s ~