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Form 668 OEPARTMENf Of TFE TEEASURY-QdTEiNAI RfVENUE SERVKE For Oprionol Use Reco?dng Ot6ce
~-}~1 NOTICE OF FEDERAL TAX li~i UNDNt iNTERNAI REYENUE UIYVS s, WCIE COUNTIf FLA•
p~~~R SERIAL NUMBER ROGCF FOI~RAS
• CLERK Ct~CU1T COURT ,
~COF.~? YEktF1E0~..._.--- .
Pursuont to the provisions of Sections 6321, 6322, and 6323 of the Internal Reve- t'(~ 32 pu 1~
nue Code, notice is hereby given that there hwe been assessed under the Internal { fl
ltevenue lows of the United States against the foltowing-named toxpoyer, taxes (indud- r~r~yC '
ing interest and penolties) wfiich oher demand for payment thereof remoin unpaid. and ~v4 J
that by viriue of the abov~mentioned statutes the amount of said toxes, toyether with
penaii'~es, interest, ond costs that may accrue in oddition thereto, is o lien in favor of
the United States upon all propery and rights to properi~r belonging to said taxpayer.
NAME OF TAXPAYER ,
Tho~as R ~ Bett Golden
RESIDENCE
214 Gardenia Ave
FT Pierce FL 33450
- UNPAID BALANCE
~ KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENi1FYING NUMBER OF ASSESSMENT
(al lbI kl ldl lel
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s 1040 12-31-72 08-03-73 158-24-4307 1,334.87
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'~5 qe~lc, ClrcuR Court
~ SL Lucie County toTi~ s Z~~4. 87
~ Fort Pieroe, Flortda
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~TME~ ~ ~ Miavi Florida • , or~ ~his,
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~ 25th of September 19 73
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~ SIGNATURE ~E .
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Chief, Office Branch
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(NOTE: Certif?ca~e of oPAcer aut ' ed br low to toke acknowledgmenh is nof aseMid to ths validilp oF Notias of F~derd Tmc lien G.CJrI
46419. C.B. 1950-51, 125.) . s~
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