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STATE OF FLORIUA
FLORIDA INDUSTRIAL COMMISSION
TALLAHASS"~E Account No,_071685->>-_
58 PAll522
Lien No.___ti~432__
........
NOTICE OF TAX LIEN
JBOP.ll\DY
ST. l UClr C~lIHn. Fl A.
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Pursuant to the provisions of S2ction ,H3,tii (3) .(a). Florida Statutes, known as thl' Florida UnemplllY-
n\l'nt Compl'nsation law. notice is hereby ~iven that there have I)e(!n aSRcssed, IHlrSulHlt to tllP provisions of
said law. a~ainst __Ole4.Y1f Ward 'rIA War4,'a a..t&\.lrUt
_.___ 9)) A_nlW "AM, )'t.. ~.ft!8, J'Jol'14.a_~ '~_-_ ______________.__.___
an "I'lllployer" liable for the' prtyment of contributions to the t'nemploYIlll'nt Compensatioll Fund of Florida.
pursuant to the provisions of saiellaw, the sum of $.__,~!.eg _ '__.._l'O\'erin~ the following- l'ontrihution,;,
inlt'n'st allll penalties, whidl after demancl for paynH'nt thereof J'l'main unpaiel. allll that h~' virtue of till'
aho\"l' nwntioned law tlH' amount of said l'ontributions (taxes). to~ether with pl'nalties, intl'rl'st, and costs
that Illay :il'l'rue in addition thereto, constitute a lien in fa\'or of i<'/orida Industria~ Commbsion upon the
tith' to ann interest, whether leKal or equitahle, in any real property, chattels rl'al, or pcrs'lIlal prolwrty of
said l'm ploYl'r.
Periods for which contrihutions, interest, and penallil's have been assessed, anel the amounts thereof, an'
as follows:
PERIOO,
~ERE!lT -'HROUGH
CONTRIBUTIONS -6
1-31 3
L-1
PENAL TIES
_I
TOTAL
\\,lTKESS THE OFFICIAL SEAL OF TIlE FLOHIDA INDUSTHIAL CO~DlISSION and thl' hand of
the Chairman thereof, at Tallahassee, Flodda, this ~a6, _ day of ___lobru&r'Y___. , A,D. l~) .' G3
SEAL
A. vor~~W~'~~
Floridn Industrial Commissiop
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