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STATE OF FLORIDA 4~~`75 1k ~
I.FS siaEY, eiiel ~ DEPARTMENT OF LABOR NdD EMPLOYMENT SECURITY
DIVISION OF EMPLOYMENT SECURITY
TALLAHASSEE 32301 Account No. 226697-A
NOTICE OF TAX LIEN Lien No. 9-10563 ,
"JEOPARDY ,
Pursuant to the provisions of Section 443.15 (3) (a), Florida Statutes, known os the Florid nemployment
Compensation law, notice is hereby given that there hove been assessed, pursuant to the provis ons of said law,
against
3600 Oleander Avenue
Ft. Pierce, Florida 33450
an "employer" liable for the payment of contributions to the Unemployment Compensation Fund of Florida,
pursuant to the provisions of said (aw, the sum of S_1I01.94 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), 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.
Periods for which contributions, interest, and penalties have been assessed, and the amounts thereof, are
os follows: "
j QUARTER(S) TAXES INTEREST THROUGH
'QTR. YEAR $-31-79 PENALTIES
1 79 601 65 12 03 2 00
2 79 X51 00 _ 2 26 1 00
t9 23 A~ i~ 2
f ILEG r=h~. ~•-..Oi~D~O
ST.LU%IE LC':%t1TY.FLA.
R~6ER Pi~1TR "
CLt:KK CIRCUIT CO T
RE GRQ YERIFI~O -
4669'75
i
SERVICE FEE -
TOTAL 1052 65 14 29 35 00
WITNESS THE OFFICIAL SEAL OF THE STATE OF FLORIDA DEPARTMENT OF LABOR AND EMPLOY-
MENT SECURITY, DIVISION OF EMPLOYMENT SECURITY, at Tailohassee, Florida, .
this 26 day of September , A.D. 1979
4
SEAL
This instrument prepared by:
Davie M. Bauldree
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