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° Tarrd ria. uGls pt~s~r. s-lsl> ~ ;
~ r STATE OF FLORIDA `
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= TAI.I~~ASSEE Aocount xo. -
~ ~ NOTICE OF TAX i.IEN No...d ~
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Purauatnt to the provisions oi Section 443.15 (3) (a)~ Florida Ststutres, known as the Florida Un~
~nploqment Cumpe~tion 4?w~ ootice ie hereby given that there have been assee~?ed~ parsuant tn the ~
provigiona of aaid ]aw~ against =e~?is~h Luu~ate
i?n "emplogrer" liable for the payment ,of contrib~tions to the Unemployment Cornpensation Fund oi
Florids, purauant ta the proviaiona of eaid law, the sum oi coverlag the tollowing .
- contributions, int~x~at and penalties~ which aiter demand iar payraent thereof r+emain anp~id, and
- thst b~ virtue of the above mentioned law the amount of said contributioaa (taxe$) ~ toS~ether with
penalties, intereat, and c~sts that may accreie in addition therEto. coastitute ~ lien in favor oi Florida
~ Industrial Com~nnie~sion apon the title to and interest, whether legal or equitsble, in any real property,
~ chattela real, or gersonal prnperty of said employer. .
Period~ !or which contributions, interest, and penalties ha~e t~en ass~saed, and the amounts
. thereof, are as fotlowe :
iNT[R[fT TNROYGM
tE!! Wp COHTMI~tlTIONf P"[NA6TIL~
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WITNE33 THE OF~'ICIAL 3EAL UF TSE FLURIDA INDU~TRIAL COMMISSION and Lhe h:und
` oi the Ch~irman thereai, at T~e1Lh~uaee, P'lorids, thia.~day oL A. D. 19a5 ~
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