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f o~ eaa pEPARTMENi OF 1}~ IREASU~'Y-NTEWAI REVEMlE SERVICE fo~ Optiond Ust Br R~~dr~y OHity
~aev.z-~~~ NOTICE OF FEDEiGI TAX LIEN UMDER INTERNAL REYENUE LA1M5 FILED ~ru AECORDED
DISTRICT ~~~~y~~ SERIAL NUMBER St.IUC~i =,OUtiT1r FLA.
R~)tiE. rJITRAS
ClfKt C ~~;U:t C4UAT ~
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P~rsuont tolheprovisionsofSettions6321,6322.ond 6323 oF the interna) Revenue
Code, notice is hereby given ihat there havebeen assessed under 1he Internal Reve- AY ~8 ~123 PH ~7~
nue laws of the Uni~ed States against ihe following-named toxpayer. taxes (including
~nteres? and penolties) which ofter demand for paymenf thareof remain uopaid~ and 3~~~
that by ~irtue oftheabove-mentionedztatutestheamount of taM taxes, together with ~
penalt~es, i~teresl, and costs that mayaccrueinaddition ihereto, ls a lien in fovor o(
the United Stotesuponollpropertyondrightsio properiy belonging to soid taxpayer.
NAME OF TAXPAYER
S~i~'~ ~ $~i"~
RESIDENCE Q
Ft P3~!'O~~ I~. 33~jZ
UNPAID BAtANCE
KIND OF TAX TAX PERtOD ENDED DATE OF ASSESSMENT IDENTIFYING NUnnBER OF ASSESSnnEN(
(o) ~d~ le~
l~i~ ~i~.~.~ lr~r~..'~ 7+1•~
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x W ITNESS my hond at ~~1~ , on thts,
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~ SIGNATURE tITIE
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(NOiE: C~~tifcoq of dfk~r outAork~d br br lo tok~ ocknowt~dpn+~nft b nof ~u~nlbl to M~ volWifp d Notfc~ of f~d~rol ior LMn G.C/w.
26119. C.B. 19SO~S1, 125.! P~~~
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PART 1-To b~ r~Min~d br r~tording offic• ~ 600K~'~Vv
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