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• STATE OF FLORIDA ~
L~EwF08RM UCT-18 DEPARTMENT OF LABOR AND EMPLOYMENT SECURITY ~i9$~S
DIVISION OF EMPLOYMENT SECURITY ~
TALLAHASSEE 32301
NOTICE OF TAX LIEN
J E O P A R D Y
Pursuant to the provisions of Section 443.141(3)(a1, Fio~ido Statutes, known as the Florida Unemplorment
Compensotion law, notice is herebr given thot there hove been assessed, pursuant to the provisions of said law,
against Custom Housing Systems, Inc. (A Fla. Corp. )
3306 Enterprise Road
Ft. Pierce, Fla. 33450
~R "emplaYrr" liable fer tke payme~! cf ccntributians 4a tbe t,lr~e~playn-~~rst Cor-~~pens~tior Fund of Flarido,
pursuant to the provisions of said law, the sum of S 3578.73 covering the following
contributions, interest and penalties, which after demand for payment thereof remain unpaid, and that by virtue
of the above mentioned luw the amount of said contributions (taxes), together with penalties, interest, and costs
that mur accrue in addition thereto, constitute. a lien in favor of STATE of FLORIDA DEPARTMENT of
LABOR and EMPLOYMENT SECURITY uoon t6e title to and interestf whettier lenol or eR~ito~le, ~n ~n~- •P~I
property, ~chattels real, or personal property of said employe-. ~
Periods for which contributions, interest, and penolties have been assessed, and the amounts thereof, are
as follows:
, QUARTERIS) T INTEREST THROUGM
QTR. YEAR AXES - - PENALTIES
I 2 80 2,391 38 95 66 15 00
~ 3 80 870 50 17 41 5 00
~ 4
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~ 80 183 78
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SERVICE FEE
TOTAL 3,445 66 113 07 20 00
WITNESSTHEOFFICIAL SEAL OF THE STATE OF FLORtDA DEPARTMENT OF LABOR AND EMPLOY-
MENT SECURITY, DIVISION OF EMPLOYMENT SECURITY, at Tallahassee, Flo-ida,
rhis 25 dor of February A.D. 19 81 .
This instrument prepared br:
Mike Smith
Department of Labor and Emplorment Securiry-
Culdwell Bldg., Tallahassee, Flo.
ssss~s
- SE~~ 1981 KIIR I I AN ~ 23
; ~~~cr ~r~c tiecoROio
' ~' S1.LUC~ECOUN~Y.FlA.
~ RQGER POITRAS
CLEAK CIRCUIT Cd1iR1
~ e~; CGRf 1': p~t .:I' ~-i~S~--- -
A~:count No. 442640
l.ien Nu. 1-2981
n0?K~~ PAGE 0~,,
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