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148033
Form Fla. UG18 IRec. 31~61)
~ ~ STATE OF FLOItIDA
FLORIDA INDUSTRIAL CO1~iNIISSION
TALLAHASSFE Account No. 7221~
NOTICE OF TAX LIEN Lien No
Pursuant to the provisions of Section 443.15 (3) (a), Florida Statutes. known as the Florida Un-
employment Compensation law, notice is hereby given that there have been assessed, pursuant to the
provisions of said law, against ~~Y"t
~t~~ Saith Zth street, lrt. Pierce, lrlao~iaa 3,3450
~
an "employer" liable for the payment of contributions to the Unemployment Compensation Fund of
Florida, pursuant to the provisions of said law, the sum of $ 3~•~~ covering the following
contributions. 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 (taxes), together with
penalties, intzrest. and costs that may accrue in addition thereto, constitute a lien in favor of Florida
Indu¢trial Commission upon the title to and interest, whether legal or equitable, in any real property,
~ chattels real, or personal property of said employer.
~ Periods for which contributions, interest, and
~ thereof, are as follows • Penalties have been assessed, and the amounts
INTEREfT THROUGH
rER IOD GONTR I SUTIONS rENALTI ES
1 ~ ~ ~ n ~ '
~
1Fti1 1 4 jF 1 1{2 ~ ~
~ F~. ~ r
~
c~ _ ~ ~ m
-=r c ~ A ~ o
o W ~'2
~ • • ri~:
TOTAL 362 58 lA 87 ~ s o
WITNESS THE OFFICIAL SEAL OF THE FLORIDA INDUSTKIAL COMMISSION and the hand
of the Chairman thereof, at Tailahassee, Florida, this~day of A~~ , A. D. 19 ~
i
SEAL ~ ~
_~~~il~..:-,t. ~
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, J D~~ Fl~orlda Industrtal Commission
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0 3
~ ~ . Boo~15 463
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