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FOfm 668 DEPARTMEkT OF THE TREAS:IRY-INiERNA1 QEVENUE $EIK'.CE For Opf+o+wl Us! BY Reco+ding OfF'rce ~
~REV_ ia>>) NOTiCE Of fEDERAt TAX UEN UNDER INTERNAI REVENUE tAll~~t~ j FtLEO an:: ~;CORDEO ~
D{StRlCT JACKSONVILLE SERIAL NUMBER ~ ST. ROC E_ L~~HRAS ~A -
CLEftK CG;CUIi COURT , ~
t r vi i n of t~on 21 6 22 ac~d 6323 of the lnte~nal Reve- pFC~k~ YE-.'?'!Ef ~ ~
Pursuont o the p o s o s Sec s 63 , 3,
nue Code, notice is hereby g~ven thot there have been asseued under the internol t
Revenue laws of the United Sta~es against the folbwing-nomed taxpayer, taxes Mar 11 i i 2e AM ~ 1~
ing in~erest and penalties) vrhich after demand for payment thereof remain unpoid. and
that by virtue of the above-mentioned statutes the amount of said taxes, together with
penallies, inte~est, and costs tiwt mny accrue in oddition thereto, is a lien in favor of ,
the United States upon aN p~operty and rights to property belo~ging to soid taxpoyer. t~r'~~~i
NAME OF TAXPAYER
Si.n~eon ~ Thalia Adderly ~
RESIDENCE ~ ` ~
2410 Coral Avernie ~
Ft. Pierce FL 33452 ~
_ UNPAID BAIANCE ~
KIND OF TAX TAX PERlOD ENDED DATE OF ASSESSMENT ~I~ENTIFYING NUMBER OF ASSfSSMENT S
(01 (bl (~I fd! (e~ -
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1040 12-31-69 07-03-70 261-14-4190 26,697.30 ?
1040 12-31-70 06-25-71 261-14-4190 25,112.52 ~
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PIACE OF ftUNG ~
; ST. LUCIE (~OUNTY ~
FORT PIERCE, ~LORtDA TOTAL 5 51,809.82
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WITNESS my hand ot Nest PaLa Beach, FL - on tfiis, :
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the Sth doy of ~q , 19 ~ S
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' SIGNATURE T1TLE ~
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C.W. Carter C lJ
(NOTE: Certificate of o!i'icer aulhorized by law ro toke ockrawledgmenh is not essentiol to the vaGdiry of Notice of Federol Tax lien G.C.M. ~
2b/i9, C.B. 1950-51, 125.) ~
PART 1-To be retained br recording office BOOK~~J~7 P!l~f~~~
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