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_ . - _ ' ; _ - , h~ ` ; ~ . • ~ STATE OF FLORIDA . i~~~`~O~ ' Foc FoRM ucT = ie ~ ' UEPARTMENT. OF COMMERCE ~ IREV. 7/7i) _ - - _ _ ; ~ U1V1SIOiV OI~ EMPL.UYMFlVT SECURITY - , ~ TALLAHASSEE 32304 Account ~o. 185062 ~ - _ - NOTICE OF TAX LIEN ~ien No. - _ - - - J ~~E O P A R D Y , - Pursuant to the provisions of Section 4b3.15 (3) (z), Florida Statutes, kno~~n as thc Florida Un- ` emplo}'ment Compensacion la~, notice is hereby given that there have bcen assessed, pursuant to the _ ~ provisions of said law, against A1~Ce H. Chavers T/A Al'S COffee ShOp - . 917 Avenue D ~ - - Ft. Pierce,-Florida 33450 - t- an "employer"~ liable for the pa~~mrnt af contributions to~ thr lincmplo~•mcnc Cump~nsation Fund of s 110.34 ~ Flurida, pursua~t to. thr pro~•isions of said la~.•, th~ ~sum of S-_ co~~rrin~ thc folloR•ing - contributions, intcrest ~nd pcnalties, ~~•hich aitcr ~irmuncl for paymcnt chcrcuf r~•main unpaid, anu - ~ that by virtue of the aba~'e mentioncd la~~• the amount o[ said contributions (ta~es), to~;ether n•ith - penalties, interest, an~1 costs that ma~~ accrue in aeidition thcreto, constitutr a licn in Fa~•ur of 5late of Floric:a Ue~arlment oI Commerceupon thc- titlc to and interest, ~~•he~hrr legal or ~quitablc, in an~~ real property, chaccets real, or personal property of said employer. - Pere~ds for n•hich contributions,-. interest, and penalties ha~•e bcrn assesse~l, and the amountti ~ thcreof. arc as follo~•s: ~ - . " ? INTEREST THROUGH - PERIOD CONFRIBUTIONS -3 31 '~S - PENALTtES 3rd Quarter 1973 11 00 _ 2$ -~9Q 00 - lst Quarter 1g74 ~ _ (Bal) 9 06 _ . - ~~~o x~_ ~~ECuRUEo - T.IUCtE ~,,~UMTY fLA. - RG~~'i= fJITRAS - - _ ~ lEk!c i i~:r,~li CrURT . • AFC~s.~_, y;:',_i:t)~~_ _ - - - _ Ma 2L -10 tu AH'75 ~ = - ~ ~ ~ {`~~8~03 . - TOTAL 11 QO ZO 99 06 - ~F'iT~i'ESS THE OF'FICIAL SEAL OF T~iE STA~'E OF~ FLORID;~ DEP~~RT1iE\T OF CO~1~fFRCE _ anJ th~~and of ihe Dir,~eetoi~( the Di~ision oi Emplo}~ment ~~uritt- ihereot, at Tatlahassee. FloridA. - - this day of Pr A. D. 19 _ - :ti'; ;.+,~1/rj. _ _ • i~ y ~ : " ~ - STATE OF FLORiDA f . . . ~.ri ~J; - = _ . ~ - DEPaRTifErT OE COV4iERCF . _ - _ ~ - - . = . - -sya . . - _ . , : _ ~ . _ _ 1' : _ t . • ~ This insirumenl~~~Ppared b~-: - _ 3_~nis~~ "Cor~nor - _ - . ~ - ~ , " R p r D~FECTOR, O~VISION OF _ Department of Cumm~rc~ gQOK fAUE ~4 EMPIOYME4T SECURITY CaldM-ell Bld~:. Tallnhas.i•~. F la. _ ~ - _ ~ _ - - ~ - - . - - _ S - - - - - - - - _ _ _~i . . !