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STATE OF FLORIL~!~ ~~9~
FO~ FORM UCT-te DEPARTMBNT OF COMMBIZCE
(REV. ~/7/1 DIVISION OF LABOR AND EMPLOYMENT OPPORTUNITIE3 `
TALLAHASSEE Account xo. 156552
Lien No. P- 37
NOTICE OF TAX LIEN
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, pursuant to the _
provisions of said law. against ~ Sarah E. Peek Lee
T/A Lee-Peek Mortuary
?28 Avenue D, Fort Pierce, Florida 33450
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 $ 71.45 covei~ng 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 w~ith
penalties. interest, and costs that may acc~ve in a~idition thereto. constitute a lien in favor of State of
Florida Department of Commerce upon the title to and interest. whether_ legal or equitable, in any real
property, chattels real, or peison~tl prnperty of said employer.
Periods for which contributions, interest, and penalties have been assessed, and the amounts
thereof, are as follov?s:
I INTER[ TMROUGM
. rE/110D CONTRI~UTIONf ~ ~ rENALT1Ei
E ~ ~
~
TOTAL ~O ~Y
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~
~ WITNES3 THE OFFICIAL 3EAL OF THE STATE OF FLOBIDA DEPARTMENT OF COMMERCE
~ and the hand of the Director of t6e Dirision of I.~bor and Employment Opportunitiee thereof, at Tallahasaee,
Florida, thia~day of Apr21 , A. D. 1972.
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