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. FILED AND RECORGIED~.
ST. WCiE COUNTY f1.A. ~
- RECORD VERlFI~O
Form FIa. UG18 ( . 3-1~1) ~
STATE OF FLOItIDA
'6l JUN 22 AN I~~Sj~A INDUSTRIAL COMMISSION
.L57`343 TALLAHASSEE Account No. ~~2
FiOGER f'OITRtiS
CI.ERK OIRCUIT COURT NOTICE OF TAX LIEN Lien No.
~c-~
JEOPABD?
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~ pnrsuant to the
provisions of said law, against J. ~.i Corooratien~
!~A Csrri~ge Banse Heataurant, Stc.
1M1 Q~..~.. 11..t..r 7~ 4t~w~~ *7w7.{A~ 2~t~.[1
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 $ 18i-~ covering the following
contributions. interest aad penalties, which after demand for payment thereof remain unpaid, and
that by virtue of the above mentioned law the amount of said contributions (taxes), toSether with
penalties, interest. and costs that may accrue in addition thereto, constitute a lien in favor of Florida
~ Industrial Commission upon the title to and interest, whether legal or equitable, in any real pmperty,
j chattels real, or personal property of said employer.
Periods for which contributions. interest, and penalties have been assessed, and the amounts
thereof, are as follows : _
INTERES? TRROUGM
rER10D CONTRIOUT10Nf rENALTIEY
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4
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TOTAL ~
7
WITNESS THE OFFICIAL SEAL OF THE FLORIDA INDUSTRIAL COMMISSION and the hand
of the Chairman thereof, at Tallahassee, Florida, this~~day of 1~ Y , A. D. 19 67
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