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NOTICE OF TAX LIEN
JBOPARDY
Account NOh_99JQ2L__-
Lien No, .~-808 ___
Pursuant to till' provisions 01 Section'."':t';> (:n (1\), Florida Statutes. known as till' Flori(la 1'I\l'llIpl".,'.
nll'nt ('ompl'nsation law, notiee is hereby ~i\'cn that there have been assessed, Inll'suant to the pnl\'ision,; "f
said law. a~ainst
Ham A. 6u:IfJ;n~r~A 8~~8 Jani~rlal Be!:y!,~________.__ .-.-
190 Bonita. Court, Ft. Pi.rQtl~,.FlCI.r1da.--..:.__ __.~..._pm"
an "em plo,\'cr" linble Col' the paYlllent of Con t I'j hu t ions tot he t' nem plo....nll'n t ('om )ll'nsa t j"n Fu nd "I' FI"rida.
pur,;uant to the pro\"isi~lIls of said law, the sum of s. J.l6..t..l6, l'o\"erin~ tIll' following- cIlntrihlltion:,.
intl'I'l'st and penalties, w'lit'h after demand for paynll'nt tlwi'eof remain unpaid, and that h,\' \'irtlll' of t h.,
allll\'l' nH'ntioned law the amount of said contrihutions (taxes), t()~ethl'I' with Iwnaltic,;. inll'n.,;t. and co,;t,;
that ma.... accl'llP in ,llldition thereto, cllnstitute a lil'n in fa\"or of Florida Indust rial ('onllni:,sion upon till'
titll' to and interest. whcthl'r le~al 01' equitable, in ;111.... I'eal properl..... chattels I"('al. or pelsonal prolwrl,\' Ilf
said l.IllJllo....er,
I\'riods for which contributions, illtcn'st, and pcnaltil's ha\'e hel'n assl'sscd. anti tlw an1l>unt,; t IIl'n'Ilf. an'
a,; follow,;:
INTEREST THROUGH
PERIOO,
CONTRIBUTIONS
PENALTIES
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4th Qu&rtar 1962
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TOTAL
WlT:\ESS THE OFFICIAL SEAL OF TIlE FLOI~JI)A I!'\Dl'STJ:IAL ('()~I:\IISSIO:'\ and till' hand elf
thl' Chairman lhl'I'eof, at Tallahassee, Florida, this, 12 _ day of " MArch
. A,D. 1!l 63 .
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A. wor~~{))~ :,~~
Florida Industrial Commi~,;ioll
'.SEAL' "7' .~' /> ';.
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