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- ~ ~ ~ STATE OF FLORIDA
FDC FORM UCT DEPARTMBIVT OF COMMEltCE ~
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D1VISION OF EMP[AYMF•PIT SECURITY
TALLAHAS.SEE 32304 Aceo~wt Na 187585-C
NOTICE OF TAX LIEN N0. _ ~-s3ie s
JROP1~?RDY ~
Pursuant co the provisions of Section 443.15 (3) (a), Floreda Statutes. known as the Elorida Un-
employment Compensation law~ notice is heceby given that che~e 6ave been assessed, pursuant to che
provisions of said law~ against ~~1e8 L. RSCe t/8 Ted' 8 Hoaqie Shop ~
f
. ~ 736 Oranqe Avenue ~
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Ft. Pierce, Florida 33450 ~
an "employe~' liable for the payment of contribucions co chc Lnemploymenc Compensacion Fund of ~
Florida, pursuant to the provisions of said law, che sum of S 59-9b: covering the foltowing i
concributions, interesc and peaalties, w6ich afcer clemand fo~ paymenc chereuf remain unpaid, and ~
that by virtue of the above meacioned laa the amount oi said concribucions (caxes)~ togethet with
penatties, interest, and costs that may accrue in addicion c6ereto, conscicuc~ a lien in favor of S4te ot
Fbrid~ Depariment of Commueeupon che ticle to and iateresc, whechcr legat or equicable, in any ~eal
property, chattels real, or personal property of said employer.
Periods for which coneributions, in~ecest, aad penalcies ha~e been assessee~, and the amouncs
chereof, are as follows;
I
~
~ QUARTER15) INTE ST TMROUGM
QTR. YEAR TAxES 5~31~•77 PENALTIES
i
, ~
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i 2 ?6 5 00
3 76 ~ 5 00:
4 76 ~ 5 00
1 77 23 16 46 ~ 15 00
2 77 6 34 ~
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- - - • - - ~
F
SERVICE FEE
`~r TOTAI 29 50 46 30 00 ;
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~ ~ITIVESS TNE OFFIC[AL SBAL OF T~ STATB OF FlARIDA DEPARTMENT OF COMMERCE
~al Ihe I~a~l - of We Direebr o! tke Divisiow o~ Brspi~~~nt See~rig tbereet. at Tallahassee. Fbrida.
~ ~ ~~~,gigg{~1~r , A. D. 19 77
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' STATE OF FIARIDA
% - ~ ERIOt~ DEPARTME:YT OF COMMERCE ~
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D~1~!'~!. ~~gi~,~0 MeMULl1AN 111
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