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STATE OF FLORIDA ~
q«F08RM UCT-18 DEPARTMENT OF L~cB~~ 'yD EMPLOYMENT SECURiTY
DIVISION OF EMPLOYMENT SECURITY
TALLANASSEE 32301 Account No. 209485
NOTICE OF TAX LIEN `-~en No. 1-3~s~
J E 0 P A R D Y
Pursuant to the provisions of Section 443.141(31(a~, Florida Statutes, k~own as the Florida Unemployment
Compensation law, notice is herebr given that thece have been assessed, pursuant to the provisions of soid law,
agoinst George Tippens -
800 Cory Campbell Rd.
Ft. Pierce, Fla. 33450
an "empiorer" tiabie for the purment oF cootributio~s to the Unemplorment Compensotion Fu~d of Fiorida,
pursuant to the provisions of said law, the sum of S 822 • 22 covering the following
contributions, iaterest and penalties, which after demand for payment thereof ~emain unpaid, and that br rirtue
of the above mentioned law the amount of snid contribufions (toxes), together with penalties, inte~est, and costs
that mar accrue in addition thereto, constitute o lien in favor of STATE of FLORIDA DEPARTMENT of
LABOR and EMPLOYMENT SECURITY upon the title to and inte~est, whethe~ legal or equitable, +n onr reol
propertr, chattels ~eal, or Qe~sonal prapertY of said employer.
Periods for which tontributions, interest, and penolties have been assessed, aad the amounts the~eof, are
as follows: -
QUARTER(S) IMTERfST THROUGH
TAXES pENALTIES
QTR. YEAR ~
, 3 80 388 75 7 78 25 00
~ 4
~
l
I 80 388 75 1
- 4 10 00
{
I
SERVICE FEE
TOTAL s 777 50 9 72 35 00
WITNESS THE OFFICIAL SEAL OF THE STATE OF FLORIDA DEPARTMENT OF LA80R ANt3 EMPLOY-
MENT SECURITY, DIVISION OF EMPLOYMENT SECURITY, ot Tallahassee, Florida,
this b dar of March A.D. 1981.
1981 NAR 19 JW ~ 36
F~tEe e,~c p~~=co~~~~o
s R06ERCPQITttASA
This instrument prepared br: c~EaKCi~cuii cou~T •
~
Alva B. Venoskie a~~r,R~~~tF1~l~~_ _ _ __-_ ~
Deportment of Labor and Employment Securitp
4 Coldwel{ Bldg., Tollohassee, Fla.
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