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- _ • ~ ,STATE OF FLORIf*1A _
L.FwS iORY UCT-1• • - - - - - _
IRE~_ si»? DEPARTMENT OF LA80R N~ID EiOYMENT SECURITY
_ DIVISION OF EMPLOYMENT SECURITY -
- _ TALLAHASSEE 32301 Account No. 0 ~ s 2 6 7 -
- - - N®°!'!CE OF' TAX Ll~N Lien No. 9-13149
Pursuant to the pra~isions of Section ~443.i5 (3) (o), Ftorido Statutes, known as the Florida Unemployment
Compensation law, notice is hereby given shot there hove been assessed, pursuant b the provisions of sold law,
agOlnSt Fnrt P~ arrP A~ oan and Rn~i~t„y Tnr ~ ~A F7 a ~ nr~~
6S~ Angle Rnad - L
Ft. Pierce Florida 33450 -
cn "employer" liable for the paymsnt of. contributions b the Unemployment Compensation Fund of Florida,
pursuant b the provisions of said tow, the sum of s 17 8 • 4 covering the following
contributions, interest and penolties, which after demand for payment thereof remain unpaid, and that by virtue.
of the above mentioned faw the amount of sold contributions (fazes), bgether with penolties, interest, and costs
?hut may accroe in addition therero, . constitute. a lien in furor of STATE of FLORIDA DEPARTMENT of
~ LAE.OR 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,. intorest, and penalties hove been assessed, and the omaunts thereof, ore
I as follows: _ - .
- QUARTER(S) TAXES INTEREST TNROUGN PENALTIES
QTR. YEAR 10^31^79
1 79 923 48 27 70 25 00
2 79 765 4t3 I1 48 15 00
22 PM ~ 2
- RE( ~
_ . - - YERIF~O
-
4'x.59
1 -
SERVICE FEE - -
TOTAL - 1 96 ' 9 I8 40 00
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~ WITTlESSTHEOFFiCiAL SEAL OF THE STATE OF FLORIDA DEPARTMENT OF LA80R AND EMPLOY-
NiENT SECURITY, DIVISION OF EMPLOYMENT SECURITY, at Tallahassee, Florida, ~
this 7 dop of pnnp..t,er- - . A,D. 19 79 -i~ - -
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This instrument prepared by: :,,r ~ "s r E _
Do7ie M. Bauldree ~ i-- _ ~ ~
Deportment of Labor and Employment Security . " ' ~ _ ~
Caldwell SidQ., Tallahassee, Flo. - r r