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fOrm 668 OE~~RIMENT OF iTiE itEllSUtY-WTEWAI lEVENUE SEQVICE For Opfia~oi Ufe eY Recwd'^9 Olfice
KOTKE OF fEDERAI TAX l~N UNDER MITERNAI REIIENUE UVYS ST.IUC C C~UNTY FtA_
t~iSTWCT SERIAI NUMBER ROC~R a~I;,~~S
.~.~,~;~t~~ : C'~:21-11VC CLEP.K C;^~UIT COURT
' RE('Qa_C v~Rcr:EO
Pursuont to the provisions of Sections 6321, 6322, ard 6323 of the Internol Reve- "
nue Code, notice is hereby given that there havc been assessed under the Internal ~p~ ~
Revenuc laws of the United States ogoinst the following-nomed to~cpayer, taxa c~~,~- 2 3~ PN~ T~I
ing interest ond penalties) which ofter demand for payment thereof remain unpoid. ond
that by virtue of the obove-mentioned stotutes the amount of said taxes, together with
penalties, interest, an~ cosh that may accrue in a~.iition thereto, is a lien in fovor of ~Ss
the United $tates upon oll propery and righls i~ properiy belonging to soid toxpoyer-
NAME OF TAXPAYER
::icl:ael :c::ti
RESIDENCE ~ _'.utci~ins ~trQet
poi~rt 5t. ~ac,,-, ?lori3a 334~~
UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
(a) ~b1 (dl (ei
341 7~~~~-7~1~ ~?":-~r-?3 ~-3J71T '-39-~~~'}~~-3 ~ '~3.0?
i
~ NLACE OF FIIING ~lerk, Cir:.ut ~o~rt
,
St. LuCle Cnu.'lty TOTAL S~'' -=3~'~;~
~ Ft. Pierce, Fl. 33!+50
~
- -
WITNESS my hond at 1'~~ ~'=~C:' ~2'~3et~ . • , on this,
the ~7"i: day of ~LUle , ~q `r~+
,
~
~lGNA7URE TITLE
/,~~.G~~'_~~ .:eve:zae ~iiicer
' • ~ir ~
(NOTE- Certifcote of officer out!wri~ed by lavv to fake ocknowleogments n not essenl~ot to ihe vahd~ly of Nofice of Fec~ol Taz lien G.C.M_
26~19, C.B. 1950-51, 125.)
U R 7j(]
PART 1 To be retained by recording office BOOK~~t7 PA~
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