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Fon11 668 DEM!'p~A9^R af 1!E 1REA9URV-~IIEaIAt REIIENUE SERVICE ~ eP R~'~ ~'4~
(REY. 1-70) 110T1~ OF ~RAI TAX t81 UNDH NTERI~IAL RE11EN1~ LIINi f ILtl1 A!~ U nt4 ItYt
~T.IUCiE COUN~r Pl~.
p~(!~T J SERIAL NUMBER ROCER POlTR11S~
CIERlI Cte~CU1T COURt
RECOq[1 YERIFIED p
P~rnuoN ~o the pro~visions of Sectia~s 6321, 6322, and 6323 of the Interna{ Rave- ~ t
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~ t~ u~d sro~ ~ fd~~~d b~. t~~ t~~~,d- :
ing iNvest and pr~+alties) which aker demand for payment tt~eof remain unpoi8. and ' '
Nw~t b~r virtue of the pbove-n+entaried siafutes the omouM of scid roxes, together with 3
penoUies, inierest. ond cosis thot mary acuve in addition ihereto, is a lien in fwor of 3 . . ~
- the lJoiled Slates dl and ri to bel i to said fo - ~
P~~Y S~ Pr~b o^9 ^9 '~P°Y~• ~ .
NARAE OF TAXP~RYBt ~ ~
T1yo~ss R. dc BsttY GoldeYt
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214 Gardenia Aveaue
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Ft. Pierae. Fl 331+50 ~
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qt~ OF TAX TAX PERtOD ENOED ASSESSMENT DATE IDENTIFlfING N11N16Bt OF A~SESSAAENT
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~ l040 1~31-?3 o5-2'T-74 1~21~4307 2. 02'l•?0
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St LuCle COwlty TOTAL : 2~~1•?0
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Fort P~sroe. Florlda
WfiAESS ~r hand aR MIAMI. FLORIDA , on this, _
1h._.21s~d~ of Iiovauber, 19 74 .
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9GNAT1JItE ~
, Chief Offics Branch
tNOTE GrN'~oa1~t of c~IGoer oulFwrix~d bqr law 1o tdc~ ~I~dp~ts is not es~entiaa b the vdid~r oi Notia d Fid~rd To~c li~n G.CJrI
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~ w11Ct ~-To b. ,,.+ain.d b~r noadi,,,~ o1Mk, 800K
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