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Form ~568 DEVA![rMENT OF if1E iREwS~.1RV-INTER1~ul REVENUE SERVICE For Opr~orwl Ust 8y Reco.dng OIFce
~r~v. i-~o~ NOTKE OF ~EDERAL TAX t1E~1 UNDNt ~lTERNAL REVENI~ tAWt .
DISTRICT SERIAI NUAABER . O;L COUN r .
14041:~ FO~TRAi
AC VVILLE C~ERK c~::~U11 COUIIT
Rf~~FD VCR.Flf D.,r..,...~,~,~.
Pursuant to the provis:ons of Sections 63~1, 6322, and 6323 of the Interno) Reve- ~1 ~
nue Code, notice is he~eby given thut there have been assessed under the Internal
Revenue iows of the United States ogainst the fottowing-narned taxpoyer,_taxes (includ- c~ryryc
i interest and alties wh;ch efier demond for ~ << 0
R9 p~ ) payment thereof remoin unpaid. ond
Ihot by virtue of the obove-mentioned statutes fhe omount of wid toxes, together with
penolties, interest, and cosh that moy accrue in addition th~reto, is o lien in fovw of
the United States upon olt property and righh to property belonging to said toxpoyer.
NAME OF TAXPAYER
Kenneth Gifford
S anish Lakes
RESIDENCE
- 16 Jacaranda Lane
C ST Lucie FL 33~50
UNPAID BAUWCE
qND OF TAX TAX PERIOD ENDED ASSESSMENT OATE IDENTIFYING NUMBER OF ASSESSMENT
~a~ ro~ <<i ~d~ ce~
10!+0 12-31-70 08-10-73 264-38-739!+ 594.02
1040 12-31-71 08-10-73 " " 351.00
PLACE OF FILING
CIBrk. ClydJtt COU/t ,
St Lucle County TOTAI i 945.02
Fo~t P~erce. Flortda
WlTNESS rrry hond ot Miami, Flo~ida ~~~a~
~ 25th of September ~y 73 -
SIGNATIlRE ~E
~ _ .
(NQTE: Certi6cote of office~ outboriz o take ocknowledpments is not euentid b the voliddy ~f R of frderd Tox lisn G.C.WI
26419, C.B. 1950-Si, 125.) ~ ~
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PatT t-To b. ..rain~a try ncordinp oRk. .
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