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STt1TL OF FLOR.IDA
FLORIDA INllUS~rRIAL COMMISSION
Tt~LLAHASSFF ~ccount 10._.4547~~ _
~-l~r~~i~l~ llT~ ~l~ 1 t' T 77~\T ~..]E?Il }\`n, _ ~-305
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Pursu<int to the pro~~i~ions of Section -1~13.15 (3) (a), Florid~i Statutes, kno~?•n as the Flc~rida L'n-
emplo~•n~ent Compensation la~~•, notice is hereb~~ ~i~~en that thei•e h~~~e Leen ~?ssessed, pursuant to khe
pi•o~-isioil:; of ~~id la~~•, a~ainst ~r?Y_~~delis__ T~A Hi11 To~Restaurant
8~t~_~~x 1~2,_E~.._Pi~s~~,_~'14ri~__33~5~ -
an "emplo~~er" liable for the p.it'ment of contributions to the Unemplo~~ment Cumpensatic?n Fund of
Flrn•ida, p.irsuant to the provisions of said la~~•, the sum of ~___5~~7~ covez•ing the follo~ving
• cuntributions, interest ancl per,alties, «•hich after demanct for p~~•n~~nt thereof 1'CI11R111 lillp~l(I, ~ind
that b~~ ~~irtue of the abo~e mentioned la~v the amount of saicl contributions (tzxes), together «~ith
penalties, interest, aiid costs th~~t ma~~ ~tccrue in addition thereto, constitute a lien in fa~~or of Florida
Industi•ia~ Commission ttpoii tlie title ta and i?itere~t, ~ti-}lether le~.il Ol• equital~le, in an~~ i•eal propei•ty,
chattels i•eal, oi• pei•sonal propert~- of said emplot~er.
Periods foj• ~~~hich eontril~utions, interest, and penalties i~a~•e been assessecl, and the ~11110UAtS
~ thei•eaf, are as follo~~~s:
~ INTEREST THROUGH
PERIOD CONTRIBUTIONS PENALTIES
i, ; nd tauarter 19b5_ 7 -
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- • ~ at i~I2,1S, CLERK
~ . .`'''r LORIDA '
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«'ITtiF.SS THE OFFICIAL SEAL OF THE FLOP.IDA INDtiSTRIAL CO~i:IiISSION ~nd the hand ~
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~ of the Ghairman thereof, at Tallahassee, Florida, this 18 day of J~u~y , A. D. 1s 66 _
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v' . ' _ : . ~T. D. Wrigh r.. Chatrman '
~ . , Flor~da Industrial Commission 1
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