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' STATE OF FLORIDA ,2'76QQ~ `'1~
FDC FORM UCT - 10 UEPARTMENT OF GOMMERCE
1REV. 7.'73i
DI~'ISfON OF ENPLOYl11ENT SF.CI?RITI~
TALLAHASSEE 3230=~ :~~count r~. 34hq~_
NOTICE OF TaX LIE1i l.~P~ tio. X-962
J E 0 P A R D Y
Pursuant to the pro~•isions uf Section 4~3.tS (i) (a), Florida Statutes, knoA•n as thr Florida Un-
empluyment Compensation law, notice is hereby given th~3t there havr been assrsse~l, pursuant ca the
provisions of said law, againsc Roosevelt Duncan T/A Duncan Masonry
1904 North 16th Street
Ft. Pierce, Florida 33450
an "cmployer" liable for the payment of contributions to~ the Cnemploti•mcnt Cumprnsation l~und of
f~ lorida, pursuant to the provisions of said laK•, the sum of S 11+~+ . 21+ co~ering che follaw~inK
contributions, interest and penalties, ~~hich afcer ~iemand for paymenc th•~reof crmain unpai.l, an~l
that by virtue of the above mentionec! lan• the amount of sai~l contributions ltaxes}, toRether a-ich
penatties, interest, and costs that may accrue in addition there~o, consticutr a lii~n in favor of State of
Florids Uepartment of CommercPUpon the title to and intcrest, ~hether legal e?r ryuitable, in .~n}' rcal
property~, chattels rcal, or personal propercy of said employer.
Per:~ds for which contributions, ir,cerest, and penalties ha~~e bccn assessed, and chr am~~un~`
thcrcof, arc as foltoa•s:
INTEREST THROUG?~ ~
' PER100 CONTRIBUTIONS PENALT~ES
3rd Quarter 197 I S 00
; lst Quarter 197 16 85 ~ 76 ~
2nd Quarter 297 58 96 ~ 77 2~S Q~
3rd Quarter 197 60 00 90
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F LE~' ~~i• ::.COr~DEO ~
~ S . LL~~C ::;:'JhTY FIA.
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: ~ C F~.r i t,i ~ COURT ~
t ~ a~r on. :,~;1 ~
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~ j = Ma ~I i2 46 PN'~~ 41 _
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TOTAL 1 Sl ~
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; V~"IT~iESS THF. OFFI(:IAL SEAL OF THF; STATE OF' F'LORIUA DEPANT~1H:~iT ()F (:O~f~iFfl(:t:
and thP hand of t6e Direcfor of t6e Uivision of Emplo}'ment Secnrih~ therPOf, at TallahassPr, Florida.
this~_da~ of FPhruarv , A. D. 19 'jl~ ~
3
' STATF OF FLORIDA
< - UEPARTME1iT OF (:011NERCF
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' This instrument pfepared bv: ~
~ -
; ~ - Al,va ~ . ~a~c-sk-~~-
- ~epartment otCo~nmerce O~RECTOq, DIVISION oF
^ EMPLOVMENTSECURITV
; Ca~d~vetl Bfcia...Tall~hassee. Fla.
= ~ ~ : - ~ - ~ : - ~ 224 ~~~E ~545
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