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STATE OF F~ORIDA ,
DEPARTMENT OF LABOR AND EMPLOYMENT SECURITY
. F;,~~ DIVISION OF UNEMPLOYMENT COMPENSATION
_ . : :
BUREAU OF TAX
TAILAHASSEE, FLORIDA 32301
~~~~5~ TE L. 904/488-7621
NOTICE OF TAX LIEtV
. ~~yer:
1~1vkF:1~ tGGt kASUNKY INC AccountNumber q:~~«;,
1.::,ti GAICNCN7 ~tiN~
PGKT ~T L4(:IE FL ~~=~452 Lien Number 4-_ 1/_ ~
P~rsuant to the provisions of Section 443.141(3) (a) and (y) Florida Statutes, known as the lien provis~ons of the Florida Unem-
~~~oyment Compensat~on Law, not~ce is hereby given that the above named emplayer is liable for the payment of contrihutions to the
tJnemployrnent Compensation Fund of Florida. Pursuant to the provisions of said law, the following contributians, interest, penalties,
and fees 4vh~ich after demand for payment thereof remain unpaid, arui that by virtue of the above mentioned law, the amount of said
cor.tributions (taxesi togeiher ~vith int~rest, penaities, and other costs that may accrue in addition thereto, constitute a lien in favor
STATE OF FLORIDA DEPARTMENT OF LABOR AND EMPLOYMENT SECURITY upon the title to and interest, whether fegal
~~r eq~itable, in any real p~operty, chattels r~:al, ar aersonat property of said employer.
Periocis for which contributions, intarest, penaltfe;, and fees have been assessed, and the amaunts thereof, arE as follows:
.
Q/YR I TAX OUE i INTEREST THROUGH PENALTY SERVICE FILING i
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~ TOTAL AMOUNT OF TAX LIEN _ ~ ~ ` ' ~
~ ~,'•dITNESS THE OFFICIAL SEAL OF THE STATE OF FLORIDA DEPARTMENT OF LABOR AND EMPLOYMENT
;:=CURITY, DIVISION OF UNEMPLOYMENT COMPENSATION, at Tallahassee, Florida, this 1~ ~
of tiuv~Mi.E.rt , A.D. 19 .
~~~~F
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~ ~ AGENCY USE ONLY
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~ r~i~~ ~ ; - ~n REMIT YO. DATE 11~ 1 ~ f ~ ~
~ r . ~ _ AMT. S NO PAY.
Yj •t+~`~~~~ 4 P.M. DATEFIIED 11/14/ ~1
J" REPORTS F.A. Da.V1S
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~ This instrument prepared by:
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_ .:HIf.L"tY LLONARU F.O. NO. ~`-A L.ONLY O.INDEBT.
Department of Labor and Employment Secunty ~
Caldweil Bldg., Tallahassee, Fla.
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