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' STATE OF FLORIDA45~239 ~ ~
I't•.S `OIREY. e;-'•° DEPARTMENT OF LABOR /WD EMPLOYMENT SECURITY
DIVISION OF EMPLOYMENT.SECURITY
TALLAHASSEE 32301 Account No. 461295
NOTICE OF TAX LIEN Lien No. 9-13191
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 A T and D Diesel Service ~ Inc (A Fla Corp )
3233 D 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 law, the sum of S 372 SO 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 ossessed, and the amounts thereof, are
as follows:
QUARTER(S) INTEREST THROUGH
TAXES PENALTIES
f QTR. YEAR
I
1 79 Bal.) 281 00 8 54
i 2 79 Bal.) 71 14 4S`7~91 82 10 00
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S ROGER
POITRAS~~
CLERK CIP.CU!T C"UR
~ 7
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SERVICE FEE
( TOTAL 352 14 10 36 10 00
WITNESSTHEOFFICIAL SEAL OF THE STATE OF FLORIDA DEPARTMENT OF LABOR AND EMPLOY-
MENT SECURITY, DIVISION OF EMPLOYMENT SECURITY,' at Tallahassee, Florida,
this 13 day of Nnvpmhpr , A.D. 19 79. - -E._` -
-
SEAL
.
. .
This instrument prepared by: - ~ '
- _ .
Marv Frances Anderson - _sc -
Department of Lobor and Employment Security ~p~Q
Caldwell Bldg., Tallahassee, Fla. _ ga~t.~(~ PIG~i~:A~
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