HomeMy WebLinkAbout0762 - 3,~~3 ~ - ~
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~ • • ' STATE OF FIARIDA 1~~ ~
FOC RORM UCT:,• - DEPARTMENT OF COMMERCE ~
IR~V• 12/7N
DIVlStON OF EMPIAYMENT SECURITY .
~ TALLAHASSEE 32304 Aceouat No. _~~4~~_
NOTICE OF TAX I1EN wM Na ` ;
Pursuanc to the provisions of Section 443.t5 (3) (a), Florida S~atutes~ known as the Florida Un-
employment C.ompensacion laa~ notice is hereby aive~ thac chere have been assessed, pursuant to the
provisions of said law~ againsc John Janes Hasburgh t/a Hasburgh Masonry ,
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3224 Indiana Court
Ft. Pierce, Florida 33450
an "employer" liable for the payment of contribucions to' thc Cnemploymenc Compcnsacion Fund of ~
626.12 ~
Florida, pursuant to the provisions of said law, che sum of S covering che folloaing
contributions, iaterest and penalties, which after demand for payment thereui remain unpaid, and
that by vi~tue of the above mentioned law the amoune of said contribucions (taxes), coRecher aich
penalties, incerest, aad costs thac may accrue in addition chereto, conscicut~ a lien in favor of SWe oI -
Fbrtda Dep~rimeaC of Commeeee upon the ticle to and iaceresc, whrcher legat or equitable, in any rcal
property, chattels real, or personal property ot said employer. i!, i
Peri~ds for which contributions, inreresc, and penalcies ha.e been assessed, -and the amouncs
' thereof, are as follows:
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i QUARTER(5) ~ T S T ROUGN ;
TAXES PE NA LT IES ~
~ QTR. YEAR '
i
4 76 1 38 u'
1 7 7 618 S 5 6 1~9 ro~t~1~
CLERR CipCUIT itt
o~~'4Pt1 YERIFfEO
- Auc ~ 9 ~3 •T ~
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3'~4583 ;
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SEi1VICE FEE .
TOTAL 61H SS ~I S~I ?
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~l'Fl~B ~HE OFFICIAL SEAI. OF TNE STAT4 OF FI~RI~A DEPARTMEIwt' OF COMMERCE
~att ll~e~ ' s ~e Dircebr ot t6e Dtvlsiox of F.oploywe~t Seeartt~ tieero~ at Tdlahassce. Florida,
thL - July ~ A. p. 19 F
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