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STATE OF FLORIDA ~1259'j
~oc coR~i~cT.~e ' UEPART~IF:NT OF ('OMMF.RI'F: ;
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I/l~'Itil(1N OF I.:~BOR AND EMI~LOYMENT OPf'ORTI?NITIES
TALI.ANASSEE Acrount No. '
• Lien No. g_7b ;
NO'fICE OF TAX LIEN
JsOPAR'DY
Pw~suant tu the pro~i.ions ot Section a~1315 (3) (a), Florida Statutes, kno~~n as the Florida l'n- -
emplo~•mer~t Compencation iaw•, notice is herebr Riven that there ha~e been as.tessed. pursuant to lhe
p~~ovisi~~ns of .aid IaN•. ~t,?ainst .~_jt. T++~ (A ~'loti~ls C~rsti~+~ -
t/a Msdi~al Dentsl Buaineaa Bunr~au . _
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~ _ Piw~w~ Fir~9 ~a - -
an "employer" iiable for the pa~•ment of contribution. to the l'nemplo~•ment ('ompensation Fund of
Florida, pur~uanL Lu the prucisions of ~id i:iN, the sum uf Zs•~! - coce~ing the fullo~•ing
rontriLutiuns, interest and penalties, Hhich atter demand for payment thereof remain unpaid, an~1
that by rirtue of the abc~~e mentianecl lavr the am~unt of ~aid contributions (taxes). togethel• ~•itfi
penalties. interest. an~i c~ists that may arcr:~e in a~1~lition thereto. constitute a lien in favor of titate of
Fl~~rida Uepartment of l'ommerce u~x~n the-t~tle to and interest. Hhether IeRal or equitable, in anc real
propert~, chattels real, ar pei~:~~nal pmpert~- uf txid empluyer.
i Peri~xl~ for ~hinc ~ontrihutic?n:. intere::t, an~i penalties ha~e been assessed, and the amounts
' thereof, are as folloN-.:
i
~ INTEREfT Ti1ROUGN
p , ?ER100 CONTRI~UTION9 rENAlT1Ef
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~ lat Qnal'tQr l~qjl l
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T_ lU IE COUNTY f~A.
R R POITRAS
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~ N'IT~ESS THE OPEI('1~1. SE:~L OF THE ~T~TE OF }t.OR1U:~ IDEPARTtiIE~T OF CO~1NERl'E:
~ and the hand uf the Uirector of the 1)ivision o( I.abor and E:mployment l)pporiunities thereof, at Taiiahasser,
" Plorida. this_l~day of JuZd 1). 19 71
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STA ' OF .FLORIDA i
SE aL - 1)EP TNENT O' COMME
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'tAir iastra~~! pr~par~d br : ~
_ f• • ~9 ~ ± ~ - ~
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D~RECTOR ~ D~VISION OF
~ neparfAmpt~~ ~loerce aU(1~194 ??1 LA ANDEMPLOYMENTOPPORT ITIES
Csld~?ell ~IdX.: Tallahaasee. Fla.
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