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~ ' ~ STA~TE 6F FLORIDA 38'~O'4 ~ ;
RDC FOAIr UCT • t~. ~
~pe~ ~:ns~ OEPARTMENT OF COMMERCE
DlViS101V OF EMPLOYMEIYT SECURITY #
_ TALI.AHASSEE 32304 Account No. 15747~ -A ~
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- NOTICE OF TAX LIEN ~en No. 7-9464 j
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. Fursuant to the p~ovisions of Section 443.15 (3) fa), Florida Scatuces, knoan as the Florida Un- '
employment Compensacion laa, nocice is hereby given thac ehere have.been assessed~ pursuant co che
provisions of said laa, againsc 8uaene J. 80r1!
t/a Donut Fair
1109~North 4th Street
Ft. Pierce, Florida 3345.0 r
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an "employer" liable for the paymen~ of contributions to thc Gnemploymcnt Compcnsation Fund of {
Florida, pursuant to the provisions of said law, che sum of S 225 • 25 covering the follow ing i
contributions, interest and penalties, which afcer demand for paymrnt chereuf rcmain unpaid, and
that by virtue of the above mentioned law che amounc of said concribucions /caxes)* cogecher wich l
penalties, interest, and costs that may accrue in addition thereto, constituc~ a Iien in fa~or of State o[
Florida Departmeai ot Commerceupon the title to and incerrst, whechcr icgal or cquitable, in any rca)
property, chatteis real, or personat property of said employer.
Peri~s for which contributions, iacerest, and penalties ha~r been assessed, anJ che amouncs
thereof, are as (olio~rs: ~
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QUARTEIi(S) - INTEREST TNROUGH €
OTR. YEAA TAXES ~ PENALTIES ~
1 77 93 60 ~ 2 34 10 00
2 77 108 23 1 08 10 00
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SERVlCE FEE - -
TOTAL ZOZ 83 3 42 20 00 ~
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~ITNESS THE OFFICIAL SEAL OF THE STATE OF FWRIDA DEPARTMENT OF C(~M1IERCE
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~nd 1hr ~~arMt~~[,~te Director of the Division o! Emplo~ment Seeuritr ii~ereof. at Tdlahassee, Florida.
this~ ~ ~'~t~~~~r . A. D. 19
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~ ~r+~~Q~~ftaaoJ~ /,,;`f~,4~'{ . 04 ~
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' o STATE OF FLORIUA
? ~ • ~ ~S DEPART111E11T OF COM~IERCE =
: J ' s#''s i ClERII CIRCf11T COa1tI~ ~
Y s _a, ; :~r ~ t7 -i RfCqRO YERIFIED~~~wji~j L. ~
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'4'!!j'~`~,~~~.~~: ~ 1 ~ PM''?T • F _
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Departa~iMl, ~n e DIRE(.TOR, DIYLSION OF
CddMtif Hit~~c.: dlah+a~%ee. Fla. `iGOX~ rA~E ~YMFNf SFCURIIY
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