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Form 666 U. S. TREASURY DEPARTMENT - INTERNAL REVENUE SERVICE ~
tR~v. Nov. i9e~~ NOTICE O~ FEDERAL TAX LIEN UNDER iNTERNAI REVENUE LAW~~,~,
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DISTRICT SERIAL NUh1BER
JACKSONVILLE, FId?gIQA-
Pursuant to the provisions of Sections 6321, b322, and 6323 of the Internal Revenue Code of 1954,
notice is hereby given that there have been assessed under the Internal Revenue laws of the United States
nn~~~~t thP f~llowina-named taxpaver, taxes lincludinq interest and penalties) which after demand for
payment thereof remain unpaid, and that by virtue of the above-mentioned statutes the amount of said
taxes, together with penalties, interest, and costs that may accrue in addition thereto, is a(ien in favor
of the United S#ates upon all property and rights to property belonging to said taxpayer, to wit:
NAME OF TAXPAYER
Harry Midelis, Hill Top Restaurant
RESIDENCE OR PLACE OF BUSINESS
4000 North Federal Fort Pierce Florida 3345~
TYPE OF TAX AND PERIOD ASSEb~CMENT DATE REFERENCE NO. ~OUNT OF
(a) ~b~ ASSESSMENT
~d)
941 Withholding 06-30-65 10-22e65 59-0596706 $ 305.77
FILED AND REC ROEp
- ' 904K
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, . ~ ~ ~ '66 FEB I 4 AM : 5 0
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~ ROGEf~ 1 ~ R.~S. ~ERK -
- . . ~ ~ = gT. LUCIE COU TY.
~ - FLORIDA
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PLACE OF fILING
Clerk, Circuit Court 305.77
St. Lucie County 7or~ _ ,
Fort Pierce, Florida ,
WITNESS my hand at West Palm Beach, Florida
, on this,
the l0eh day of February , 19 66
DISTRICT OIRECTOR OF INTfRNAL REYENUE aNre) ~ TITLE
F S SCHMIDT Thanas C. Graves
~ (NOTE~ Certifimt~ of ofticer a~lhorized by law to take acknowledgments ts mt euential to the validity of Notics of federal Tax Usn G.~;(V~.~L}419, C.B.
~ 1950-51, 125.1 n R ~~~i ,~'~~I
= PART 1- To b~ retained by recording of~ic+~ 600K u ~t,iV