HomeMy WebLinkAbout0965 _ ~G
F.xm 66A DEPAItT?~AEM Of ?HE iREARHtY-rJTEMAI kEVfPMIE SEiNKf For Usa BY Reoording OtRc~
trt~v. ~-~o~ NOTKE OF FEDERAL TAX l~l UNDBt MiTdtNAL REYENUE U1WS aa'~ ~
DISTRICT SERIAL NU/NBER Cl£RK ~.~UlT ~OURT
JA KSONVILLE *«pRi~ Yi'~~f~f~
Pursuant to the prowsions of Sections 6321, 6322, and 6323 of the Internol Iteve• ~ il w~~~
nue Code, notice is hereby given thaf there have beeo assessed under the Internol Ni1
Reve~ue laws of the Un+ted Stotes against the following-named toxpoyer, taxes (includ-
ing interest ond penalties) which after clemond for poyment thereof remain unpaid. ond
that by virtue of the obov~mentioned statutes the amount of said taxes, together with i~~ri~~$
penofties, interest, and costs that may actrue in oddition thereto, is a lien in favor of
the United States upon all propertr and righh to propery belonging to said roxpcyer. .
NAME OF TAXPAYER ~
e ald R S~ Doroth ~i Hair
RESIDENCE _ -
10'L West :iorth Park ST
'i Ukeechobee FL 33474
UNPAID BALANCE
E KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDB~1TIFlfiNG NUMBER OF ASSESSMENT
; l01 rol kl tdl te1
~
j 1040 12 -31-72 08 -06 -73 262 -46 -5882 481. 72
P
~
i
S
~ ~
~
g
~
F
~ •
N
~
~
~
sy "
rs
~
~'s'
~
` PLACE OF FILING
(:I@I'~(. ~iI~CIJIt ~:Oltft t
. ~ TOTAL S 481.72
~
Fort Pleroe, Florlds
_
~ WITNESS my hand ot Zliacni Florida , on this,
-
~ _
the 25th ~y of JanuarY , 19 74 .
:5
~
~
~
3 SIGNATl12E TITLE
_
~ Chief, Uffice Branch
'N~
(NOTF: Cerrificate of off~cer authora aw to to~e ockrwwledgmenK is not essential to fhe volid~y of Notice Mof
Feduol Tox l+en .C.M.
- 26419, C.B_ 1950-S1, 125.) D~~%'_{ ~
_ ~+v
_ PART 1-To be aefaned by recording ofFice _