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iORY F~A. UC-1~ (~EY. j-1-6S)
STATE OF FLORIDA '
FLORIDA INDUSTRIAL COMMISSION
TALLAHASSEE Account No.11.1282 `
- NOTICE OF TAX LIEN Lien No S"~
JLOPARDY
Pursuant to the provisions of Section 443.15 (3) (a), Florida Statutes~ known as the Florida L'n-
emplo~ ment Compensation law. notice is hereby given that thei~e have been assessed, pursuant to the
provisions of said law. aAainst ~~ld Higginbothem
Raute 2 Hou 873-H, Ft. Pierce, Floric]a 3:451
an "emplo~er" liable for the payment of contriUutions to the Unemployment Compensation Fund uf
Flo~-ida, pursuant to the prorisions of said law, the sum of $ covei~ng the following
contributions, interest and penalties, ~erhich after demand for payment thereof remain unpaid, and
that by virtue of the alwve mentioned law the amount of said cont~~ibutions (taxes), together K ith
penalties, interest, and casts that may accrue in a~ldition thereto, constitute a lien in favor of Florida
Industrial Commission upon the title to and intei~est. ~~hether legal or equitable, in any real property,
chattels renl~ ot• pe~~on:~l property of said emplo~e~•.
I
Periods for which cont~~ibutions, inte~~e.~t, and penalties have been assessed, and the amounts
thereof, are as folloHS:
.
INTEREfT THROUGH
P[RIOD CONTRItUT10NS rENALT1Ef
4th r 1 ~ ~
~ ~ 10 00
2n~uarter 1 ~ i. L UC! t C v ~~~1 ~Jr ]A 00
- ~ . . _ . 1 53"70 ~o 00
ra r 1
-6 PM ~'23 ;
~t~ ~
- , c~~rir
~ LA M
~ TOTAL W - W
4 1VIT~F.SS THE OFFICIAL SEAG OF THE FLORIDA ]A'DL'STRIAL COMDiISSION and the hand
~
~ ot the ChairmAn thereof, at Tallahassee. Floi~ida, thi~.,~-day of ~+~,h , A. D. 19 69
~ ` .
S~:AL : _ _ . ~ ' • W ~
= ~~m.,~
Fior I trial Commfasfon
- ' . ° This mstrumtnl prcparcd b.~: .
_ _ : _ ~c x- garuer
FlonAa Induslnat Com~~ss~on
~ g~i~ C~IAwtll BIAq.. tallaha~stt, Fla.
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