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STATE OF FLORiDA '749848 1
LES FOkM UCT 18 DEPARTMENT OF LABOR AND EMPLOYMENT SECURITY FEB e~~ S
(REV. 9/84) DIVISION OF UNEMPLOYMEN'1' COMPfNSAT10N
BUREAU OF TAX
T14LLAFIASSEE, FLORlW132301
TEL 904/488-7621
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NC~TICE OF TAX LIEN
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v„ Employer: GL jMAllt HILL, Account Number 045313T
HIL~-~ PLASTEkING
3~01 KENTIlCKY AbE Lien Number 4-03215
FT P IERCf= FL 3345U
Pursuant to the provisions of Section 443.141(3) (a) and (g) Fbrida Statutes, known as the lien provisions of the Floricia Unempbyment
Compensation Law, notice is hereby given that the above named employ~er is liable for the payment of contributions to the Unempbyment
Compensation Fund of Florida. Pursuant to the provi,sions Qf said law, the fdlowing contributions, interest, Qenalties, and fses which after
demand for payment thereof remain unpaid, and that by vi~tue of the above mentiaied law, the amour~t of said contributions (taxes) together
with interest, perialties, and other costs that may accxue in addition thereto, constitute a lien in favor of STATE OF FLORIDA DEPARTMENT
OF LABOR AND EMPLOYMENT SECURffY upon tha tftle to and interest, wPiether legal or eq~itable, in arry real property, chattels real,
or personal property of said emplaj+er.
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Periods for which cantributions, interest, penafties, and fees have been assessed, and the amounts thereot, are as falbws:
oivR ux ~ a~reaesr n~+aouoH ~wurr sEav~ FluNc
DUE fEE FEE
, 02/G 1/f36
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i= ; ~/t3 ~ 114 .7 S 1. T2 15 . ttt7~
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TOTAL AMOUNT OF TAX l1EN 131 ~4T
WITNESS THE OFFlCIAL SEAL OF THE STATE OF FLORlDA DEPARTMENT OF LABOR AND EMPLOYMENT
`_~E=CURITY, DIVISION OF UNEMPLOYMENT COMPENSATION, at Tallahassee, Florida, this ~n
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F AGENCY USE OtrlY
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~ ` aEMrr No. a?re 3/ 5
= ao~ 493 F~~E 954 a ~~Y.
PJ~A. DATE FlLED tt tt ~
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~ REPORTS FA 3
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This instrument prepared by: ~
~ 5?i I H 1.~ Y l~ CiNA R D F.o. r~0. 2-2 A 5 6 ~ or?~v o. u~oEar ~
~epartment d Labor and Ert~lo~yment Security
CaJdweH Bldg., Taliahassee. Fla-
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