HomeMy WebLinkAbout0993 STATE OF FLORIDA ~ ~
DEPARTMEIV'f OF LABOR AND EMPLOYMENT SECURITY
~ ~ ~ DIVISION OF UNEMPLOYMENT COMPENSATION
.
BUREAU OF TAX
TALLAHASSEE, FLORI~A 32301
TE L. 904/488-7621
6~~8fi5 NOTICE OF TAX LIEN
.::~~yer_
~ NAPA i1F FGR7 PI El2C~ IN~. Account Number C..
AliTO SUPPL.Y
:it55 ~.FtAJ~vE A~"tt~ttrt lienNumber :,,-~;;;,lr.
F T P I~RC:E FL s3454
Purs.,ant to the provisions of Section 443.141(3) (a) and (y? Fiorida Statutes, known as the lien prov+sions of the Fiorida Unem-
;;!c;yR~ent Compensai~on Law, i~otice ~s hereby given that the above named employe~ is liable for the payment of contributions to the
Unemployment Compensation Func! of Florida. Pursuant to the provisions of sa~d law, the following contributions, interest, penalties,
~rc! fees ~vhich after demand !or payment thereof remain unpaid, and that by virtue of the above mentioned law, the amount of said
~;or~tributior.s (taxes! toyether with mtPrest, penaities, and other costs that may accrue in addition thereto, constitute a lien in favor
~.~f STATE OF FLORIDA DEPARTh~ENT OF LABOR AND EMPLOYMENT SECURITY upon the title to and interest, whether legal
,r eyuitat~la, in any real property, chattels r~.al, or personal property of said empfoyer.
Paria;s for which contribufions, ~ntar~st, prnalties, and fees have been assessed, and the amounts thereof, are as foilows:
QlYR j TAX OUE -T INTEREST TNROUGN PENALTV SERVICE FILING ~
! OUE FEE FEE
' 11/Q 1/t34
~ - ~
_ r/:s4 A~ .};;s•y~ i ~•O1 I l~.ai.. i
~ ~ fi8U86 I
r ~ ; f ~
; i
~ ~ ' { '84 !OV 1 1 :l 1
~ ; ; ; ~ ~
~ ! ~ FILE~ • ~
~ j ~ ~ ROGE~ i ' .
~ ~ + ~ i ST. Lt1C~. ~ -
& ; ; ;
~ j ; ~
~ I ' ~ ~
~ i ' ~ I
- ~
:
~ TOTAL AAtOUNT OF TAX LIEN
4~r~ITNESS THE OFFICIAL SEAL UF THE STATE OF FLORIDA DEPARTMENT OF LABOR AND EMPLOYMENT
;:=CURITY, DIViSION OF UNEMPLOYMENT COMPENSATION, at Tallahassee, Florida, this i=.:
i,~y of hc.v~Mr'.tt~ , A.D. 19 aa
d~~~F
' i~~ AGENCY USE ONLY
~ ~ ~
; ~;~'1(~'4~ p~;f ~ ~ j REMITNO. DATE 11/14/8~I
~ ~ AMT. S NO PAY.
~ ~ r s P.M. DATE FILED 11/? ~I/84
R S ' REPORTS F.A. D'3V1 S
This instrument preparec~ by: ~ ~ ~
~
~ _ ~H1 RLEY l.E6JNARD F.O. NO. 2-~A L ONLY O. INDEBT.
Departrr~ent of La~or and Employment Security
Caldwell Bldg., Tallahassee, Ffa.
~
~
- - - ~ ~ -
~