HomeMy WebLinkAbout2795 _
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- ,STATE OF FLORIDA ~~"~1
LFS ` c~ si»~ DEPARTMENT 01= LABOR AND. EMPLOYMENT SECURITY_ _ ~ -
DIYISION OF EMPLOYMENT SECURITY -
- TALLAHASSEE 32304 Account No. 157471•A
iVQTIC~ ~F 7`A~C LIEN Liea tYo. 9.6250 -
J B O P A R D Y
Pursuant to the provisions of Section 443.15 (3) (a), Florida Statutes, known as the Florida Unemployment
Compensation law, notice is hereby given that there hove been assessed, pursuant to the provisions of said law, -
against Eugene J. Norn -
t/a Donut Fair 1
2209 N. 4th St.
Ft. Pierce, FL 33450
on "employer" liable for the payment of contributions to the Unemployment Compensation Fund of Fiorido,
pursuant to the provisions of said law, the sum of _S 42.00 covering the following
contributions, interest and penalties, which after demand for payment thereof remain unpaid, and that by virtue
of the above mentioned law the amount of said contributions (taxes), ogether with penalties, interest, and costs
that may accrue in addition thereto, constitute a lien' in, favor of STATE of FLORIDA DEPARTMENT of
LABOR and EMPLOYMENT SECURITY- upon the title to and interest, whether legal or equitable, in any real
property, chattels real, or personal property of-said employer.
Perlod5 for which contributions, interest, and penalties have been assessed, and the amounts thereof, are
as follows:
QUARTER(S) INTEREST TNROU N
QTR. YEAR TAXES ~ ~ PENALTIES
4 78 S 00
1 7s 27 00 ~qi9 SAP 19 PN 2~ 02 l0 00
A~A ~r">IRa
t~ER1t - T c t
RECORD VER1FtED
~a).7s+1I - _ _ _
SERVICE FEE -
ToTAL 27 00 IS 00
WITNESS THE OFFICIAL SEAL OF THE STATE OF FLORIDA DEPARTMENT OF LABOR AND EMPLOY-
MENT SECURITY, DIVISION OF EMPLOYMENT SECURITY, at Tallahassee, Florida,
this 14 day of June A.D. 19 79
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This instrument prepared by: ¢ fr
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Barbara A. Peterson : '
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Deportment of Labor and Employment Security ~.j
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Caldwell Bldg., Tallahassee, Fia. °~j.•== .~~,z