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STATE OF FLORIDA
FLORIDA IIJDUSTRIAL COMMISSION
TALLAHASSEE Account No.
NOTICE OF TAX LIEN Lien No R'~
JEOPARDY
Pursuant to the prnvisions of Section 443.15 (3) (a), Florida Statutes, known as the Floi-ida LTn-
err~plo~~ment Compensation law, noiice is hereby given that there have been assessed, pursuant to the
pi~y~io~s of said
1~~ ~ainst s L. D. Bnl~erts ~ad L. J. Ssavsr as co-partasrs
~ ~i ~taa~s
, Route 12, ~ingto~ ~I~rl~ I~noocvills~ 'lbnnesses 379~
an "employer" liable for the payment of contriUutions to the Unemployment Compensation ~nd of
Florida. pursuant to the provisions of said law, the sum of $ 38•~ covetting the following
contributions, interest and penalties, which after demand for payment thereof remain uapaid, 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 a~ldition thereto, constitute a lien in favor of Florida
Industrial Commission upon the title to and intei~est, whether legal or equit~tble. in any real property,
chatteis real, or person~l property of said employ er.
j Periods for which contributions, interest, and penalties have been assessed, and the amounts
j thereof, are as follows:
I
E ~~~cs~r TMwou~M
~ r[IIIOD CONT111~UTIONf ~ ~ rENALT1Ef
~ 4th 4usrt.er 1967 ~ 50 9~ 1 00
~ ;
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D
~
~ TOTAL ~ 5O ~ ~S W
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~YlT1ESS THE OFFICIAL SEAY. OF THE FLOP.IDA INDUSTRIAL COMMISSION and the hand
of the Chai~man thereof, at Tallaha.~see, Flo»da, this 7 rlay of ~~a' , A. D. 19
: •
SEAL..~~= , FILE~ A~~~ RECORCEQ ' ~
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' ' ! (1 f+T 2 6 Ptor I t Hal Canmisslon
~ ~B ; I S P~~ This ins~nin~cn~ p?cporcd 6y:
; . . - Mar~? x• Harp~o~
~ ~ ~ FloriAa Infiis~rial Co~+~~ss~un
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s CLEhit CiRCUIT COURT Caldwtll Bldq.. Tellahassee Fla.
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