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~ STATE OF FLORIDA - J~ v
Foc For~w ucT-~s DEPARTMENT OF COMMERCE
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DIVISION OF BMPIAYMENT SECURITY
TALLAHASSEE 32304 A~o,~~ no. S q~
Liea Na 4-83$
NOTICE OF TAX LIEN . ~ ~
Pucsuant to the provisions of Section 443.15 (3) (a). Florida Statutes, known as the Florida Un-
employment Compensacion law, notice is hereby given thac chere have been assessed, pursuant co che
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provisions of said law~ against Sharon Anne Psge T/A Dor Room ~
2703 South Federal HighWay
Ft. Pierce Florida 33k5~
an "employer" liable for the payment of contributions co" the Unemployment Compensation Fund of
Florida, pursuant to the provisions of said law, the sum of a ~+7 • 29 covering the follo~ ing
concributions, interesc and penalties, whuh a[ter aemana fior payment thrrruj rriiiain unpac::, ~.?z~ .
chat by virtue of the above mentioned law the amount of said contributions (taxes), togecher with -
penal~ies, interest, and costs that may accrue in addition thereto, constitute a lien in favor of State of ~
Florida Departmenl ot Commerceupon the title to and interest, whethcr legal or equitable,.in any real
property, chatcels real, or personal property oE said emQloyer.
Periocis for which contribucions, interest~ and penalties ha~~e been assessed, and che amouncs
thereof, are as fellows:
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IMTEREST THROUGH
PERIOD CONTRIBUTIONS ~ PENAlTIES
2nd Quarter 197 17 10 1 03
3rd Quarter 197 13 55 61 10 00
~ 4th Quarter 197 5 00
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ST. UC'E ;~~HTY FIA.
I GGE~ ~J:7RAS ~
CLE 1 C ;i,U~T COURT
Frnf-
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S TOTAI 30 65 1 64 15 00
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~ITNESS TNE OFFICIAL SEAL OF THE STATE OF FLORIDA DEPARTNENT OF COMMERCE
~ and ihe hand of t6e Dtrector of t6e Division of Employment S 7 ritr thereof. at Tallah~ssee. Florida,
ihis_.2_day ot AuKU s t , A. D. 19 4
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• ~ ~ STATE OF FLORIDA
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•r. - - - - DEPARTMEI~T O~ C01113fERGE
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, - D~RECTOR, D~VISION OF
DE~2 j~ EMPLOYMENT SECURITV x
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