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Form 66H OEPARTMENT OF THE iREASINtY-WTE@IAL REVE1~lUE SERYICE For Optia~ol Use By RKwdeg
~~u ~-~ot NOTICE OF fEDERAI TAX tIEN UNDER INTERNAI RFVENUE LAWS :~~uc~E couw
DISTf~CT SERIAL NUMBER ROCiR ~OtTF~S
~ Jacksonville CLERx CI~:~UfT COURT ~
RFCORO VfP,iF1E0
Pursuant to the provisions of Sectioru 6321, 6322, and 6323 of the Internal Reve- ~
nue Code, notice is hereby given fhat there have been osseued under the Internal ~ 1~
Revenue laws of the United States ogoinst the foltowing-~amed taxpoyer, tuxes (includ- -
ing i~terest and penalties) which oher demond for payment thereof remain unpaid. and s
that by virtue of the obove-mentioned statutes the omount of soid roxes, together with 2'?'352'~ ~
penah'~es, interest, and cosh that may accrue in addition thereto, is a lien in fwor of '
the United States upon al) propernr and rights to properiy belonging to said ta~oyer.
NAME OF TAXPAYER
Gera ld F Hair & L"r. ~if f in PTR
Gerald ~ Hair S~ Aseocistes
RESIDENCE
i 10'L W H Park Street ,
; Ukeechobee F1 33472
i UNPAID BALANCE
i KlND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IQENTIFYING NUM86t OF ASSESSMENT
~ lal l61 kl ldf (e1 a
~ 943 12-31-72 8-27-73 59-1459513 2,631.05
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PLACE Of FILING
_ qerk. Circuft Court TOTAI ; 2~631.05 ~
S~. LUCte COU11l~/ f
= FOrt PI@f+c9~ FlOrlds ~
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Wl7NESS my hand at Fl ~"S• ~
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'X~ rhe _24thdar of -~~~Cat-, t 5~4 ~
StGNATURE i1TLE -
~ Chief, Office Branch
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(NOTE: Cc~tificote of oRicer cutho y!aw to foxe ack~owledgmenh is not essentiol to fhe voi~d~y of Notice of Federol Tax lien G.C.M.
26419, C.6. 1950-51, 125.) +
_ PART 1-To be retained by recording oRKe acc~c?2~ s"!1',{ '
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