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Fotm Fla. UC-18 (Rev, 3-1-61)
- STATE OF FLOItIDA
FLORIDA Il~TDUSTRIAL COI~~IVJ~ISSION
TALLAHASSEE Account No. 125752
NOTICE OF TAX LIEN Lien No M-Q2
JEOPAR~DY
Pursuant to the provisions of Sec ion . a, orida Statutes, known as the Florida Un-
employment Compensation law, notice is herebr-given that there have been assessed, pursuant to the
provisions of said law against J. J. P. , IriC. ( A Florida Corporation ~
T/A Carriage ~iouse Restaurant and Lounge
~ ool ~paw~.oi nr~ve F~ Pierce, F~ oride 33450
an "employer" liable for the puyment of contributions to the Unemployment Compensation ~nd of
Florida, pursuant to the provisions of said law, the sum of $ 59 • 91 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. 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 eqnitable, in any real property,
chatteis real, or personal property of said employer.
Periods for which contributions, interest. and penalties have been assessed, and the amounts
thereof, are as follows: ~
INTER[iTTMROUGN
~Elt10D CONTRIOUTIONS ~~~1~~/
~ PENALTIEs
2nd Quarter 1967 5 1 F~L AND RECpRQE~`
.
p COR~ Y~RIFIED
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'61 -A11.: 2 9 AM ~ ; ~5
:r i°~~TR:.S
TOTAL 59 91
WITNESS THE OFFICIAL SEAL OF THE FI,ORIDA INDUSTKIAL COMMISSION and the hand
of the Chairman thereof, at Tallahassee, Florida, thiA ~3 day of AuguBt A. D. 1967 •
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