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STATE OF FLORIDA f
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~oc FoF~M IjCT - ld ~ DEPARTMENT OF COMMERCE
(AEV. 7%i31
DIVISION OF EMPLOYMENT SECURITY
TALLAHASSEE 32304 Accouat No. 181412
Lien No. 5-1043
~M0~4 NOTICE OF TAX LIEN
Pursuant to the provisions of Section 443.15 (3) (a), Florida Statutes, known as the Florida Un-
employmenc Compensation law, notice is hereby given that there have been assessed, pursuant to the
provisions of said law, against Ch8t1E8 E. B811 T/A Charlies Car Wash
3705 Whiteway Dairy Road
Ft. Pierce, Florida 33450
an "employer" liable for the payment of contributions to~ the Unemployment Compensation Fund of
Florida, pursua~c to the provisions of said law, the sum of = 33.83 covering the following
contributions, interest and penalties, which after deroand Eor payment thereof remain unpaid, and
that by virtue of the above mentioned law the amount of said contributions (taxes), together with
penalties, interest, and coscs that may accrue in addition~thereto, consticute a lien in Eavor of State ot
Florida Departmeni ot Commerceupon the title to and interest, whether legal or equitable, in any real
propercy, chattels real, or personal property of said employer.
Periods for which contribucions, interest, and penalties have been assessed, and the amounts
thereof, are as follows:
INTEREST THROUGM
PERIOD CQNTRIBUTIONS PENALTIES
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~ 2nd Quarter 1973 (Bal) 3 50
f 3rd Quarter 1973 33 25 00
! 4th Quarter 1973 5 OQ
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7
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2 TOTAL 33 33 50
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j WITNESS THE OFFICIAI. SEAL OF THE STATE OF FLORIDA DEPARTMElYT OF COMMERCE
~ and the hand ot t6e . Direebr oi t6e Diviaion of Employmenl Security Wereot. at Tallahassee, Florid~.
~ Wi~ -._~_d~r o~ ,~~c~hri~a rv
,A.D.19 75
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~ r.:~Y ' - p,D~gF ~ ~0~ DEPARTME1VT OF COMMERCE
~ . - tIER[ CthGU1T i~ YRT "
~ s~"' - = •w _ NECt~RO YEF~f~Ed
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~ T ! - . ' ~~.6;~ 1~1 IO N ~M'75
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~ Alva~'~v TV~~oekie
~ Departmeot of Commeree ~~4 OIRECTOR. o~visioN oF ~
' EMPl.OYMEHT SECURITY ~
t Caldwell Blda.. Tallahassee. Fla.
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