HomeMy WebLinkAbout01-5556UC-728 REV. 6-98
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
DOCKET #
DATE ENTERED
CERTIFIED COPY OF LIEN
TO THE PROTHONOTARY OF SAID COURT:
Pursuant to Section 308.1 of the
Pennsylvania Unemployment
Compensation Law, 43 P.S. § 788.1,
this is a Certified Copy of Lien for
unpaid unemployment compensation
contributions, interest and penalties to
be entered of record by you and
indexed as judgments are indexed.
PENNSYLVANIA EMPLOYER
ACCOUNT NUMBER: 21-18877 8
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
VS.
TOBY L COY
INDIVIDUALLY & T/A
DON COY'S GARAGE
SOUTH EARL ST EXTD
SHIPPENSBURG
PA 17257rf~~· (.; , ,
AD Number: 291585
CONTRIBUTION [INTEREST DUE ON UNPAID PENALTY DUE -
QTR/YR,
CONTRIBUTION ANB / OR LATE REPORT/
DUE PAID/CREDIT BALANCE CONTR~BIJT~ON PAID LATE. DISHONORED CHECK
3-00 WE .00 .00 .00 .00
3-00 496.94 .00 496.94 40.17 49.69
4-00 WE .00 .00 .00 .00
4-00 331.30 .00 331.30 19.88 33.13
J 828 · 24 60 · 05 82 · 82
sub-total
Additional interest is to be computed on the above balance of unpaid unemployment
compensation contributions at the rate determined by the Secretary of Revenue
under Section 806 of the Fiscal Code, 72 P.S. § 806, per month, or fraction of e
month, from 09/30/2001
Filing Fee(s) 9.00
Additional Interest
R. SCOT MIEDRICH
Assistant Director, Bureau of Employer Tax Operations
TO BE RETAINED
BY RECORDING OFFICE
o9/o /2oo:]_
DATE
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