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STATE OF FLORIDA
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. ; , ; . _ DEPARTMENT OF LABOR AND EMPLOYMENT SECURITY
. DIVISION OF UNEMPLOYMENT COMPENSATION
BUREAU OF TAX
TALLAHASSEE, FLORIDA 32301
TE l. 904/488-7621
f~~37852
NOTICE O~ TAX LiEN
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t3l~kTi.jN CI7F.U5 MARVE;aTII~V tNC AccountNumber
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F7 PIEKGE . FL 3:;450 LienNumber _i~
Pursuant to the provisions of Section 443. ~41(3) (a) and (y) Fiorida Statutes, known as the lien provisions of the Florida Unem-
,~loyment ~~ompensat~on Law, not~ce is hereby given that the above namPd employer is liable for the payment of contributions to the
Unemployment Compensation Fund of Florida. Pursuant to the provisions of said taw, the following cantributions, interest, penalties,
ar~ci fees wh~ch after demand for payment thereof remain unpaid, ai~d that by virtue of the above mentioned law, the amount of said
r_ontributions ttaxes} together ~vith ~nterest, penaities, and other costs thai may accrue in addition thereto, constitute a lien in favor
uf STATE OF FLORIDA DEPARTMENT OF LABOR AND EMPLOYMENT SECURITY upon the title to and interest, whether legaf
~>r equi*,aole, fn any real property, chattels r~~al, or personal property of said emplpyer.
Periais for ~vhich contributicns, ~ntarest, penalties, and fees have been assessed, and the amounts thereof, are as follows:
Q/YR- i- TAX OUE T INTEREST THROIIGH PENALTY SERVICE FILING
I ~ 11/O1/;.4 DUE FEE FEE i
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TOTAL AtAOUNT OF TAX LiEN 1. =,t~ l.
; :"~+1TNESS THE OFFICIAL SEAL OF THE STATE OF FLORIDA DEPARTMENT OF LABOR AND EMPLOYMENT
:~GURITY, DIVISION OF UNEMPLOYMENT COMPENSATION, at Tallahassee, Florida, this ~
tvC.VEMEFii t~4 ~
~,:y of , A.D. 19 . ~
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6 ~ ~ REMIT T10. DATE 11/14/84
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y' Fe ~.M. DATE FILED 11~I~I~84
REPORTS F.A. D3V~S
This instrument prepared by: ~ ~
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~ ~Ht FL.tY LEUNARC F.O. NO. 2°~A " 1 L. ONLY C. INDEBT.'~
Department of Labor and Emplcyment Security
Caldwell $Idg., Tallahassee, Fla.
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