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Form G60 OEPARTMENT Of iHE TREASURY-INTE2NA1 Rc"VENUE SfRY1CE fw Oplional Usr By Recor~ng Office
~REV. iao~ NOTICF OF FEDERAL TAX UEN UNDER tNTERNAI REVENUF lAWS ' -
DISTRiCT JACK30I''lILLr; : SERIAL NUMBER ~ ~ _ ~Q~~~C ,
a,~
Pursuant to the provisions of Sections 6321, 6322, and 6323 of the Inter~al Reve- - `
nue Code, notice is hereby given ihat there have been assessed under the Intemal - i
- Reven~~~ lows of the UniterJ Stoles against the folfowing-named taxpayer, taxes (includ- _
_ ing interesl ond penalties) which after demand for payrnent thereof remain unpaid. and _
that by virtue of the above-mentioned statutes the amount oF soid tuxes, together~ with ~
penalties, inlerest, and cosh that moy accrue in addition thereto, is a lien in favor of z
tfie United States upon ofl property and rights to properfy belonging to said taxpayer.
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- NAME OF TAXPAYER _ - - ~
{
- ~dward J Kenr~ec3~y _ - - '
RESII~ENCE 212 Rainie Lane ~ ^ _ - ~
POI`t. $t L12C1@~ F'~. ~J^*S~ -
- - UNPAtD BALANCE
KIND OF TAX TAX PERIOD ENDED ASSESSM~~NT DATE IDEt~ITIFYING NUMBER - OF ASSESSMENT ~
(a) ~b1 - (d} (e~ Y
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_ 1t~o - 12-31-?3 10_21..74 - 375-42-99F~ 3:240.53 . ~
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: SL Ltl~?t L~L+lt7Y FIA. •
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, Har 11 I 47 PH'7~ _
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~ P1.AC~ OF FILING - t
; . C18rk, Cir~ult ~o~ttrt ~
f- St~ LuCie COUMy TOTAL i 3~ 240.53
~ ~ Fort P~en~, Flon~ ~ :
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~ WITNESS my hand at ~i„~ Florida - - _ - - , on this. -
- - _ - . . ' ~ - - F
~ 1Sth ~,y of j•~Y , t 9 75 - - _ : - - -
- ~ s~cr~nnx~E _ nr~E - - -
~ ~~i Chief. Office Branch - _
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(NOTE: CertificoFe of ofl'icer cru?twriz - law to toke oclcnowledgments is nof esseMial to the volidiy of Notice of Federd Tax Lien G.CJ+~1.
26~19, C.B. 1450-51, 125.)
- PAStT 1-To be retained br rvcat+din~ of~ic~ ~ $OOK ~ PAGf ~tlV ~ ~ . .
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