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HomeMy WebLinkAbout0059 i t - ~ t: j - . , . - - - - _ - - - _ l~era bitLtF il. S. TRE/?iURY DEP ~ - txttssu?~ REvfNUE SERtlI~•E _ Fsr ~wwl u,. ~Y R«si:~ OiR~e+ t2-v) - tENT~K~1E Oi ~EA~.~f l~AL TAX l~M = ~ DISTlICT _ ' ~ SERIAL ~LO~> - : 201064 b-188 1003 - 4~~~' 1 betohtr _ N 10 AIM fO110~Mi11~YgMd M7t~O~f'a11M fpV:hNllla Of SsltiiOfl - - - - 634Sh). latnewol Rewnw Cost. kevo boon sotisfiad •it6 teo*ost to the tmcos' enu- ~ _ ~oreted bolew, tMothor Mith ell statutory odiitions Provido~-1~ Socttan 6321: o~! ~ .~N ~ toot the lion far i~eh to~oos awd stetatary odditiews iws-lMeoblr boon nleosod: Tho ~ ~ 20 - pre~or officsr in tbo effia whoa notice of intoneol-eewnw tax lien was fibril on - 8 ~1, wo~hpT " 17th , -19~Q_, !s b~orolgr authorized /o osob nototiaa ~ on his beaks to shwr the nbwse of soil lien, inseie? os tM 'liew rekhs to the ~ . ~ foikrwinp tows. - - ! - i NAME OF TAXPAYER"- - - _ ~ MEQi~~ ! i l'!ba'Oe~ l - _ - RESIDENCE ~ ~ ~ - _ i ~ ~ ~ ~ 1 UNPAID BALANCE - j T!U( FORM MAMR~B PERIGJ ENDED ASSESSMENT DATE IDENTIFYlNG.NUMBER OF ASSESSitENT (o) - (c) (d) (e) , "~r•r f i - ~{'i+i0 12ra~~ 7~3~9*7~0 ?.~~1i~6~?l~~ t ~ Z~ ~s?~~~ ~ ~ PLACE OF FILING ~~s ~ - TOTAL s 17~~ i ~ - i ~ - i t NOTICE Of f'EDERAL TAX LIEN REf ILIN6 - - b-239 p-212- IRS SERIAI NuMeER~"~ fit - REC~RDfR•s IDEMi1F1G1TION No. -307115 . - s NUTKE HIED WITH_ ~ ! ~ _ DATE 5'~-~ -~;i, # _ _ TAXPAYBY - - f diikent than shown abo+re) sIGNATU TITiE _ Jacksotzville Plorida V~ITNESS mfr bond at - _ , on this, ~ 21st ~ ~ Dec er i9- t9 - - ~IGNATURE g~ g, p ~ ~ C./ ~ (fief , _ Specf el Procedures Staf f v~ ~ (NOTE: Ce~tiBwte of ofd cwlkorized by kwr b ~ scknowiad~atents is ewt essential to the ralidihr of Notice of Fodaral Tax Lien ` G.C1N. TM19, C.d. i9SQ-1, 125.E