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UC.728 REV. 6-98
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
DOCKET # f)a::o-ll.>to3 ~.
DATE ENTERED '2>\ IIjDC>
CERTIFIED COPY OF LIEN
~q,O<::>fd c.LU:I (Q02,()LQ R.i:I: q 30cn
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
TO THE PROTHONOTARY OF SAID COURT:
Pursuant to Section 308.1 of the
Pennsylvania Unemployment
Comj)ensation Law, 43 P.S.S 78.8.1,
this is a CertifiedCoPV of Lien for
unpaid unemployment compensation
contributions, interest and penalties to
be entered of record by you and
indexed as judgments are indexed.
vs.
.
JAVIEL TORO
INDIVIDUALLY & T/A
J C'S PIZZA
2213 OLD GETTYSBURG ROAD
CAMP HILL PA 17011
.
PENNSYLVANIA EMPLOYER
ACCOUNT NUMBER: 21-19700 9
AD Number:
284200
QTRlYR.
DUE
CONTRIBUTION
PAID/CREDIT
BALANCE
INTEREST DUE ON UNPAID
CONTRIBUTION AND I OR
CONTRIBUTION PAID LATE.
PENALTY DUE
LATE REPORTI
DISHONORED CHECK
3-99 WE
3-99
.00
205.33
.00
.00
.00
205.33
.00
6.50 .00
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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 01 the Fiscel Code, 72 P.S. fi 806, per month, or Iractlon 01 a
month,lrom 03/31/2000
The undersigned, Director, Bureau of Employer TaK Operations, Department of Labor and Industry, certifies that the above unemployment compensation contributions, Interest and penalties
are due and payable by the above named defendant under the provisIons of the Pennsylvania Unemployment Compensation Law. Pursuant to Se'ctlon apS.1 of said Law, 43 P,S. ~ 788,1,
the above contributions, Interest and penalties are a lien upon the franchises and property, both real and personal, IncludIng after acqUired property, of the above named defendant and
attach thereto from the date of entry of this Certified Copy of Lien.
RJutP1~
R. SCOT MIEDRICH
03/02/2000
OATE
AssIstant Director, Bureau of Employer Tax Operations
TO BE RETAINED BY RECORDING OFFICE
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