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FLORIDA INDUSTRIAL CObI]~IISSION
TAI,LAHA33EE
NOTICE OF TAX LIEN _
Account No -~-
Lien No. ?-~
Jsos~>t<>.i
Pursuant to the provisions of Section a , ~ orida Statutes, known as the Florida Unemploy-
ment Compensation law, notice is hereby given that there have been assessed, pursuant to the provisions of
said law, against !t • Mf z'o~ i'!f]a! std Ooasts~totloa • Ino • ~ ~~~ Oos~rsltion)
an "employer" liable for the payment of contributions to~ the ZJnemployment Compensation Fund of Florida,
pursuant to the provisions of said law, the sum of E 385.1 covering the following contributions,
interest and penalties, which after demand for payment thereof remain unpaid. and that by virtue of the
above mentioned lbw the amount of said contributions (taxes). together with penalties, interest, and costa
that may accrue ih addition thereto, constitute a lien in favor of Florida Industrial Commission, upon the
t)tle to and interest, whether legal or equitable, in any real property, chattels real, or I~bpFaPe~?' of
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said employer. ,.~•~ ~a~~ ~ -~ ~ ~- •~~> > ~ .
Periods for which contributions, interest, sand penalties have been assessed. and ~ou~fs. ~he?eof~ ~_ .
as follows: _ _ :,, .'t ~ :.~~._`;~ : -
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WITNESS THE OFF'ICIAb REAL OF THE FLORIDA INDU3TRIAI. COMMISSION and the hand of
the Chairman thereof, at Tallahassee. Florida, thin ~ day of Dao~r , A.D. 18~ .
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A• ~~ ss~ Florida Ind trialua~Cognmiaaion
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