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Form 668 DEYARTMENT Of TME ?REASIMY-MTERNAI RFVENUE SERVKE Fo. Opriaal Us~ By Remrdng OR'~ce
~~v. ~.io~ NOflCE Of fEDERAI TAX UEN UNDBt HrTERNAI REVENUE lA1MS ~kp t~K a
DISTRIC7 SERtAI NUMBER ~~,111C1E ~Oy~~Y ~ : ~
JACKSONVILLE ROC[~ P01 pA! •
CLERK Ct~G~~t Q9UItf
Fr,QRP vE~'FfEO.~.~.~s
Pursuant to the provisions of Sections 6321, 6322, ond 6323 of the Internal Rev~ '
nue Code, notice is hereby given that there have been assessed under the Internul
Revenue lows of the United States against the fotlowing-named toxpoyer, ttixes (includ-
ing interest and penalties) which aher demand for payment thereof remain unpaid. and
that by virtue of the above-menlioned s~atutes the amount of wid taxes, together with
penolties, interest, and cosh that may accrue in addition thereto, is a lien in favor of
the United Stotes upan all property and righh fo property belonging fo said toxpayer.
NAME OF TAXPAYER ~QW~2
James H. 6 Owenette Boozer
RESIDENCE !+[~09 Pressler Lane
Ft. Pierce, FL 33450
UNPAID BALANCE
KIND OF TAX TAX PEWOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
(al (~1 kl ldl (el
1040 12-31-72 06-04-73 261-66-7210 $349.11
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~ PLACE OF FILING aerk, ClrcUtt COUIt
a TOTAL :349.11
St lucie County
; Fort P~eroe, Flohda
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~ WIINESS my ha?d ot Miami, FZorida
, on this,
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~ ~e 4th ~ of April ~~5
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~ SIGNATURE T1TLE
~ Chief, Office Branch
f NOTE: Certificote of ofFicer ovthwued bp to take ocknowledgments is not euential to the vdidily of Nofics of Federol Tox lien G.C.MI
26I19. C.B. 1950-51, 125.) 0 R M~ ~~pp
~t BOOK ~
e~ PACE OCJ
- PART 1-To be retairwd br ncordirq o1~ke
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