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0~?ARTMEMT OF THE TREAtU11Y-tMTEpNAI IIEYENUE SERYICE " FW ~?tipWi 1/ie By ReCOrding Olficr # -
Form 668 '
(REr. ~sas~ MOTICE Of fEDERA! TAX LIEN UNDER INTERNAL REVENtlE ~AWS
OI ICT SERIAL NUMBER .
Jackso~ville,Florida ~ ~ ( - ;
Pursuant to the provisions of Sections 6321, 6322. a~d ~323 of the Internai Revenue Q~~ ~
~~~Y~ L~~ y
Code, notice is hereby given tfiat the~e hava been as;essed under the Internal Revenue laws g~ RR C~ ~T ~au~r ~
of the United States agairut the follawing-named taxpayer, taxes i~ncluding interest and NF60k!! y~R; ~~~y~~ ~
penalties) which ahe~ demand fw payment thereof remain unpaid, and that by virtue of
the above-mentiened siatutes the amount of said taxas; together with penalties, inte~est, Q yo ~?C
and c~osts that may actxue in addition the?eto, is a lien in favo~ of the United States upon N~T ! O .
all property a~d tights to propeny belonging to said taxpayer.
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NAME OF TAXPAYER -
xo~ra F. x~, ~c. 328468 ~ .
c/o Mi11er, Dreggors & Shierling 3~~ .
• RESIOENCE ~ - ~
P 0 Box 2979 - , ~ ~
Deland,Florida 32720 ~ - ;
~ UNPAID BALANCE ~
KINp OF TAX TAX PERIOD EN~ED DATE OF ASSESSMENT - IOENTIFYING NUMBER OF ASSESSMENT ~
!al (bl fc1 ldl Itl '
I 940 12/31/73 0l/28/76 59-i3?8o61 5.T2
' 1~20 04/30/74 c~l./28/7'6 59-13'78061 9312. 54 ~
! 9~ - 12/31/72 01/28/?6 59-1378061 30.53
~I g41 06/30/73 oi j28/'Tb 59-137806~. _ u5. 53_ ~
f 9~1 03/31/73 0l/28/76 59-13?8061 35.oz. ;
~ 94i _ 09/30/72 O1/28/76 a 59
1378061 843.18
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~ PLACE OF FILING Clerk of the Circuit Court ~
~ St. Iakcie Cbunty TOTAL g 10342.51
~ Ft. Pierce,Florida ~
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WITNESS my hand at Orlando,Florida , on this,
the l~~tfay of Februar_v_ , 19 76 ~
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SIGNATURE . ' TITLE ~
Q, a. 0~~~ Revenue OfPicer :
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(NOTE: Certific~ts oi otiicer wthwizad by Iaw to tak~ ~ck~owNdQmer?ts is.~ot essM[isl to tM validity ot Notla o1 FW~?N T~~c ~ Ci.C.M.
26~19, C.B. 1950-/, /25.) ~Q ~l ~K
(~I~ s~ ~
PART 1- To be re~ained by recordin9 aifice
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