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UC.728 REV, ,.97
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
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DOCKET /I CJ<i? 1../0 ~u.jJ
DATE ENTERED TI'..r'M
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LATE REPORT!
DISHONORED CHECK
CERTIFIED COPY OF LIEN
U q,l;C) (",I (,~11.5".33'15 Po U lJ>055&
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 01 the
Pennsylvanls Unemployment
Compensation Law, 43 P.S.!i 788.1,
this Is a Certified Copy 01 Lien lor
unpaid unemployment compensation
contributions, Interest and penalties to
be entered 01 record by you and
Indexed as judgments are Indexed.
vs.
.
.
W R FOOD INC
T/A WESTERN ROSE PRODUCE
1302 SLATE HILL ROAD
CAMP HILL PA 17011(") J.l
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CO
PENNSYLVANIA EMPLOYER
ACCOUNT NUMBER: 21-18975 8
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AD Number:
273728
OTR/YR. CONTRIBUTION
DUE PAID/CREDIT
1-95 WE 59.14 59.14
1-95 1,972.46 1,972.46
2-95 WE 57.82 57.82
2-95 1,076.61 1,076.61
3-95 WE 56.02 56.02
3-95 560.59 560.59
4-95 WE 56.65 56.65
4-95 313.14 313.14
1-96 WE 12.39 12.39
1-96 763.02 763.02
2-96 WE 14.33 14.33
2-96 437.58 437.58
BALANCE
INTEREST ObE ON PAID
CONTRIBUTION AND J OR
CONTRIBUTION PAID LAtE.
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
11.49
23.32
4.70
8.41
3.09
2.80
sub.total
.00
53.81
53.81
9.00
AddlUonallntara.t la to ba computad on tha abova balanca of unpaid unamploymant
compensation contributions at the rate determIned by the Secretary of Revenue
unda, Sactlon 806 of tha A.cal Coda, 72 P.S, 6 806, par month, or fraction 01 a
month,from 12/31/1997 .
Total
Filing Fee(s)
, Additional Legal Costs
Additional Interest
Satisfaction Amount
The under,IBnld, Olrlc:lot, BUI..u 01 Employ., Tal OPI'lllonl, Oll:lar1mlnl 01 Labor and Indu.try. clr1lfll. thallhl abOVI un.mj:lloymlnt comj:l.n.allon conlllbullon..lnttll.t ana p.naltll'
arl aUI ana payable by lhl above namea dlflndant unae' the previ.lon. of Ihl Penn.ylvanla Unemployment Compenulion L.aw. Pultuant 10 Secllon 308.1 of uld L.aw, 43 P.S. 1188. "
the al....ve conlflbutlon',lnterl.t and plnalll.. a'l allln upon the franchl... and proplrty. bolh ,.., and peltonal.lncludlng atle: acquired j:lroplrty, of Inl above namla dlllndanl and
anacn Ihlrllo I,om lhl dlle or Intry olthl. Clr1iflla Copy of Uln.
12/22/1997
DATE
TO BE RETAINED BY RECORDING OFFICE
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IN THE COURT OF COMMON PLEAS OF CUHBERLAND
COUNTY. PEN~SYLVANIA
=,
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR &. INDUSTRY
to the use of the
UNEMPLOYMENT COMPENSATION FUND
Docket Number 9B 40 CIV
\'5.
W R FOOD INC
TIA WESTERN ROSE PRODUCE CO
1302 SLATE HILL ROAD
CAHP HILL PA 17011
AUTHORITY TO SATISFY
TO THE PROTHONOTARY OF SAID COURT:
NOW. to wit. APRIL 7 1998 the Commonwealth of Pennsylvania.
Department of Labor and Industry. to the use of the Unemployment Compensalion Fund.
Plaintiff in the above action. through its Chief Counsel. by its Depuly Chief Counsel for
Employmenl Securily. acknowledges ha\'ing received of the Defendant above named full
payment and satisfaction of the above captioned Lien. wilh the interest and costs thereon due
it: and desire that satisfaction be entered upon the records thereof.
AND you. the Prothonotary of said Court. upon receipt by you of your costs, are
hereby authorized and empowered. in the name and stead of the Plaintiff. to enter full
satisfaction upon the record of said Lien as fully and effectually. to all inlents and purposes.
as we could were we present in person to do so: and for so doin&. this shall be your
sufficient warrant of authority.
IN TESTIMONY WHEREOF. there is hereunlo affixed the Seal of the Department of
Labor and Industry. Commonwealth of Pennsylvania. this 7 TH day of APRIL . 1998.
ACCOUNT NO. 21-18975
AD NO. 273728
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SEAN F. CREEGA
Deputy Chief Counsel for Employment Security
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