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STATE OF FLORIDA
LES FORM UCT 18 DEPARTMENT OF tABOR AND EMPLQYMENT SECURITY
(REV.9/84) DIVISION OF UNEMPLOYMENT COMPENSATION ~
BUREAU OF TAX
TALLAHASSEE, FLORIDA 32301
TE L. 904/488-?~21 ? V~ 2,~
NOTICE OF TAX ~IEN ~ ~ ~ P2~7 ~ .
FIlEO l,.'i; r .'~'tv U
Empioyer: RQ~ ER PU!? w.::;
~ Ki.AESEM PROTi'iEAS~ IMCORNORATLD Account Number 180p1~ ST IUCIE C~'_ v`Fi K
CMRIiTEMtEN•AO
P G 60a[ ~Z Lien Number ~r-114~1
RT PIERCL FL 'J'JA6Q
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Pursuant to the provisions of Section 443.141(3) Ia) and ~y? Florida Stat~~tes, known as the lien provisions of th~ Florida Unem-
pioyment Compensation Law, notice is hereby given that the above named employer is liable tor the payment of contributions to the
Unemployment Compensation Fund of Florida. Pursuant to the provisions of said law, the following contributions, interest, penslties,
and fees which after demand for payment thereoF remain unpaid, and that by virtue of the above mentioned law, the amount of said
contributions (taxes) together with interest, penalties, and other costs that may accrue in addition thereto, const'stute a lien in favor
of STA7E OF FLORIDA DEPARTMENT OF LABoR AND EMPLOYMENT SECURITY upon the title to and interest, whether legai
o? equitable, in any real property; chattels real, or personal property of said employer. ,
i Perials for which contributions, interest, pena~ties, and fees have been assessed, and the amounts thereof, are as follaws:
t .
QJYR 7AX DUE INTEREST THRQUGH PENALTY SERVICE FIUNG
9b/~ ~88 OUE FEE FEE
~ 4/84 6!Q•77 ,S.1S -~5.00
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TOTAL AMOUNT OF TAX LIE(V 63G.96
NJITNESS THE OFFICIAL SEAL OF THE STATE OF FLORIDA DEPARTMENT OF LABOR AND 6THLOYMENT
SECURITY, L~VISlON OF UNEMPLOYMENT COMPENSATION, at Taflahassee, Florida, this
day of Y , A.D. 19 85
d ~F
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` A(3ENCY USE ONLY
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- REMIT NO. DATE 5 21 5
a~ I~ ~ ~ - ~ AMT. S NO PA'!._
~ t'= ~ P.M. DATE FILEO S~ 5
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REPORTS F.n. DSvis
7his instrument prepared by: ~ ~ ~ ,F.A. NO. OOIO1
~~~Y LE~~ F.O. NO. A Sb l. ONLY O. INDEBT.
Department of Labor and Employment Security
Caldwell @Idg., Tallahassee, Fla.
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