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Form 668 DEPARTMENT Of iHE iREASUYr-1NTE(~1A1 REVENUE SERVI~E Fn+ Opliarw! Une 8y Recordng OlFice
;r~v ~-~o~ NOTiCE OF FfDERA! TJ1X t~N UNDBt 1N~NtNAI REV'ENUE UWS F~t,~~ ~wL eECO~~
DISTRIC7 SERIAL NUMBER St. L11C1E ~OSfMn FLL
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(SQ~T.I,E ~~Y~ ROCE R POl i RAS
Ct.fQK CI;+CUii COURt
RFCQRII Vffti~lE?
Pursuant to the prov~sions of $ections 632T, 6322, and 6323 of the Internol Reve- -
nue Cade, notice is hereby given thal there have been assessed under the Internoi /~.T ~y ~2 23 PM ~~3
Revenue laws of the United Stotes against the following-named taxpoyer, taxes (includ- w
ing interest ond penalties~ which ofter demand for ~wyment thereof remai~ unpaid. ood
that by virtue of the above-mentioned stotutes the omount of wic! toxes, together with
penolties, irtterest, ond costs that moy occrve in addition thereto, is o lien in fovor of
the United Sta!es upon al! prope~ty and rights to properly belonging to said taxpayer. ~CMy~~~
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NAME OF tAXPAYER
Gerald Jame
RESI~ENCE
Rout@ 1, Box 709 .
Fart Pierce Flo~ida 33450
i UNPAiD 6ALANCE
KINU OF TAX TAX PERJOD ENOED ASSESSMENT DATE IDENTIFYlNG NUMBER OF ASSESSMENT
(al ro) l~l td) (el
Chicaqo, I12.
941 1Nithholding 69-12 T•31-?0 36-2668200 S 3,601.7?
' Chicago~, Ill,
; 941 Withholding 70-03 lr+26~T0 36-2668Z00 324.A0
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PlACE OF HUNG
: Clerk~ CiTCVit COUrt TOTAL t 3~926.17
} St. Lucie County
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vVITNESS my hand ot wAst._Palm 8~ach,. Flaa~ida , o~ ~h?~
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the _2~h__day of ~ct'1+~+ssr , 19
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S!G ~ ~ TITLE
ZHI~I~tAS C• GRAVES GRqJP 1~INAGER
; (NOTE: ~amficote of o(fxer wthorized by 1aw to toke odcnowledgments a rtd esserdid ro the volidiy of Notice of '~ederd Taoc lien G.CM
1 26119, C.B. 1950-51, 125.)
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PART 1-To be r~efain~d br roco?din~ olflc~
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