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FILEd AND RECORDED
ST. ~UCiE COUNTY flA. j~t~O
R~CORD VERIFI~O
Foran Fia. C- (Rev. 31~1
STATE OF FLOItIDA ~
'6l APR 26 AM 8: y6
15~~ FLORIDA INDUSTRIAL COI~~IMISSION
:i0 ~I_~ ~•utT?~ti5 TALLAHASSEE Account No.
C~ERK C~RCU~T COURT NOTICE OF TAX LIEN Lien No z'~
- JBOPAHDY
Pursuant to the provisions of Section 443.15 (3) (a), Florida Statutes, known as the Florida Un-
employment Compensation law, notice is herebp given that there have been assessed; pursuant to the
provisions of said law, against ~be~ 1[. Al].iaan /A Tii?+~+j *fe ~d Pbo? a
b~1~8o~tb-i~d~_4a~..~,.,~„~.~.-?`~. F3,~ae~c~,--~']~+o~id~-~~~han
an "employer" liable for the payment of contributions to the UnempIoyment Compensation ~nd of
Florida, pursuant to the provisions of ssid law, the sum. of ~ covering the following
contributioas, interest and penalties, which after demand for payment thereof tem~un unpaid, a~d
that by virtue of the above mentioned law the amouut of said contributions (taxea), together with
penalties, interest, and costs that may accrue in additian thereto, conatitute a lien in favor of Florida
Industrial Commission upon the title to and interest, whether legal or equitable, in atiy real property,
chattels real, or personal property of said empIoyer. ~
Periods for which contributiona, interest, and penalties have been assessed, and the amounta
thereof, are as follows:
INT[11[fT TNROYGM
r[It10D CONMl~UTIOIif ~ENALTIEf
i
{
TOTAL
i
WITNESS THE OFFICIAL SEAL OF THE FLURIDA INDUSTRIAL COMMISSION and tlie`hand
of the Chairman thereof, at Tallahassee, Flarida, this~~.day of ~'u , A. D. 19 67
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