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• STATE OF FLORIDA - 9~~~~4
i0(R~~ ei»t QEPARTMENT OF LABOR AND EMPLOYMENT SECURITY
DIVISION OF EMPLOYMENT SECURITY
~'ALLANJISSEE 324 Account No. 701012
- lVOTlGE O!~` 'T'AX .LIEN Lien No. 9-8478
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Pursuant to the provisions of Section 443.15(3) (a), Florida Statutes, known as the Florida Unemployment
Compensation low, notice is hereby given that there hove been assessed, pursuant to the provisions of said taw,
against _ Hardy Lee ~illiame
;a;ag~-AvoAi~o=li• 1201 No. 27th Street, Apt. 63
Ft. Pierce, Fl. X3450
an -"employer'-' liobie for the payment of contributions to the Unemployment Compensation Fund of-Florida,
pursuant to the provisions of said low, the sum of s 222.62 coveting the following
contributions, interest and penalties, which offer demand for payment thereof remain unpaid, and that by virtue -
ofthe above ~~~aationed law the amount of said contributions (taxes), together 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. f
Periods for which contributions, interest, aed penalties hove been assessed, and the airtounts thereof, ore
as follows:
QUARTER(S) 7A7tES INTEREST TNROUGN
qTR. YEAR - _ PENALTtfS
4 77 5 Q0
1 78 5 " 00
2 .78 167 57 10 05 - 25 00
3 78 19 SEP 19 PN r 02 10 00
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~ f1C~ COUtfTYp
POtTRAS
C~C1NT T
11ERIflEQ
4~96~4
SERVICE FEE j
TOTAL 167 57 10 05 45 00 l
WITNESS THE OFFICIAL SEAL OF THE STATE OF FLORIDA DEPARTMENT OF LABOR AND EMPLOY-
MENT SECURITY, DIVISION OF EMPLOYMENT SECURITY, of ea, Florida,
this 3 aQy of Auctust , ~',,s , ~ ,i~
, A.D. i9 79. - ` y~`
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This instrument prepared by: ` '
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Alva 8. Venoakie -
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Department of l.obor and Employment Security
Catdwell Bldg., TQliahassee, Fla. _ .