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Form Fia. UC-18 IRev. 3-1-61j
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STATE OF FLORIDA
FLOPiID~ INDUSTRIAL CONIIvIISSION
TALLAHASSEE Account No._ 4~T~?
NOTICE O~' TAX LIEN Lien No.-~ ~~T-
Pursuant to the provisions of Section 443.15 (3) (a), Florida Statutes, known as the Floricia Un-
employment Compensation law, notice is hereby given that there have been assessed, pursuant to th~
pro~ isions of said law, agxinst 2a~~ ~~a~ ~tion~
C. ~c ~"'j', ~ . ri~. ~'laarids 33~51
an "employ er" liable for the payment of contributions to the Unemployment Compensa.tion Fund of
Florida, pursuant to the provisions of said law, the sum of $~-T~ covering the following
eontributions, interest and penalties, which after demand for payment thereof remain unpaid, and
that by virtue of the above mentioned law the amount of said contributions (taxeg), together with
penalties, interest, and costs that may accrue in addition thereto, canstitute a lien in favor of Florida
Industrial Commission upon the title to and interest, vvhether legal or equitable, in any real property,
chattels real, or personal property of said employer.
Periais for wliich conti-ibutions, interest, and penalties ha~ e been assessed, and the amounts
thereof, are as follows: ~
INTj1~~T j~JROUGH
VERIO~ CON7RISUTiONE g/~y/~j PlNA4TIE8
lrt qu~artez 1965 ~ 32 ~~~OR~ ~
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WITNESS THE OFFICIAL SEAL OF THE FLORIDA TNDUSTftIAL C~MMISSION and the hand
. of the Chairman thereof, at Tallahassee, Florida, this_~_day of ~p'~~~r A, ll. 1S'~
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r'.• J ~ ~ cha~~n
' i:-.~ - ° , ' ' ~d"rfda Industrial Commiesion
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