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ST~ZTE OF FI.(~RI[)t1 ST. ! !"'IE CC'~N71'< <LA.~
FLORIDA INDLTSTRIRL COMMISSION ~ • - ~- - - ---'
TttLLAIIASSEI~; Account ;\'o,~1Q49~$-
NOTICN: OF TE~X LIr:'_V Lien No. •~
l'ursu;urt to the pru~•isiuns of Section <l 13.15 (3) (tt), F101'Ida Sttitute5, kno~~~n as the Florida Uncmplny-
mcmt ('rnnprnsatiun la«•. notice is hereby"gi~•en that there ha~•e been assessed. hursuftnt to the provisions of
T,wrt T.. Qi_llnrt T+/A Plnri~~ 1!'tnver t?ilmreaa "
~.~ill lay+', atcain,t --~ ---
_____---1604 ,~d}/.L_! Rna~~_~._Yia*~ns~~'laridr------ - --
;ur '•cmplr~rer" lial,le fur the payment of contributions to the l'nemployment Compensation Fund o- Florida,
pcrsu:urt to the pro~•isions of said la~~', the sum of S--1Q~Q.2?-------co~•erinf; the fol!awinl,~ contt•ihutions,
int~•rest and penalties, ~ehich after demand for payment thereof remain unpaid, and drat by ~•irtue of tyre
ah~l~•e nu•ntioneci lava the amount of slid contributions (taxes), together ~~•ith penalties, interest, and costs
that nr;y accrue in addition thereto, constitute a lien in fa~•or of Florida Industrial ~ammission upon the
title to and interest, ~ti•hether let*al or equitable, in any real property, chattels real, or personal properly of
swill employer.
I'eriucis for ~ti•hich contributions, interest, vxl penalties ha~•e been assessed, and the amounts t.hereoi', are
as fullu~ss: '
PERIOD
CONTRIBUTIONS INTEREST THROUGH
1~- 1-62
PENALTIES
-
P~ O ap
Year Q1P ~Q~_--
1st quarter 1 1 ~5
126
~
11
•
6 ev
~ rn
c~ ~ t
~
_
_
res barter 1 1
4th carter 1 1 ~
20
6
~ ~ al
2' z-~ ~
.~
n
o~ ~ ~
_ a~ ~
TOTAL
1~'IT'~I;SS'I'fiE OFFICIAL SEAL OF THE FLOI:IDA II\'DUSTI:IAL CO\IIIISSION and the hand of
the Chairman thereof, at Tallahassee, Florida, this_2__ _day of___~Yember _, A.D. 19-d~.
. '~; ' •`+.. ~ _ - Chairman
', • . ' - _ . • , _ . A. Worley Bra`+n
~- Florida Industrial Commission
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