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oEV,,~r?u~ENr oF r?~E ~Ewst~r-rtrE~ eFVer~ue sEev~E Fo. op~~wwi us. er RecwdMe OI~CS i
Form 668 p E ~
~~REV. ia»> NOTKE ~ FEDERAL TAX LI9~! UNDER ~tNAI REYENUE LAMIS ~~40AM C~~O ~~A~`~ F
DISTRICT JACKSONVILLE SERIAL NUMBER
Q4~RK ~~CUIT a011~~''~
~[COR~ Y~R1f1[D~..w.~..,r
Punuant to the provisions of Sections 6321, 6322, and 6323 of the Internal Rev~
nue Code, notice is hereby given thaf M~ere have been assessed under the Internal ~
Revenue laws of the United States against the folbwing-named taxpayer, taxes (includ- ~
ing interest ond penalties) which after demand for paYment thereof remain vnpoid. a~d
that by virtue of the above-mentioned statutes the omount of soid taxes, together with ~
penakies, interest, ond costs that may occrue in addition thereto, is a lien in favor of 2~3~0
the United States upon oll property and rights to prope~? be~onging to said taxpayer.
NMAE OF TAXPAYER - ~
M. G. Cooper }
cts ~
aE51DENCE ~
P.O.. B~x 1689
Fort Pierce, FL 33452 ~
UNPAID BALANCE ~
KIND OF TAX TAX PER10D ENDED DATE OF ASSESSMENT IDENTIFYlNG NUMBER OF ASSESSMENT ~
tal tbl k1 ~d~ ~e~ ~
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! 941 p(y-30-74 09-30-74 59-13?1609 8~183.31 ~
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PLACE OF FILING •
~ ST. LUCIE COUNTY TOTAL S 8,183. 31
FORT PlERCE, fLORIDA
WITNESS my hand at M?est Palm BQeCh~ , on this,
the 7th ~y of OCtob6T , 19 7'4
SIGNATURE ' ~ T1TLE
i
G. A. S RPE Acting C~oup b~anager ;
(NOTE: Certificofe of olFicer avthorized by law to take acknowled9ments is no1 asentiol to the volidify of Notice of Fedaol Tax lien G.C.M. {
26419. C.B. 1950-51, 125.) ~ R~~ ~('j(~ ~
PART 1-To be retained by recording office ~OOK P11Gf QE~
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