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HomeMy WebLinkAbout98-05216 , , " j ! 1 I I I 1 I I ,\ : , ,. ." " No,q f.5,.2.1(", " c,IVIITerm , '1. , " JJ.iL~AJ1~~d- all1felllS ~1l'p~ . .. , I' I JEMka( . ~ . .'.1 !, V$, R.Jip,.Je.~~4l\f"'tVJj-?=~ ' - " '! court of common Pleas " CUl11b.CO; I I' I l \ " I, 'I' \, " " I j, ",. i " i " I ! '- I Ii I " I' I i , ! I I , i , . tA \ " " " " 'i' I, ! !. '. \( ; ~!l' "IKI'. \: < . . t i 'i '" .1(1 ,.'.. \' I ' '. ~ \\ I ,. 'f-'h \~'\ . ,\ ~\\I'~:\, "" 'I' LI ',,'''' "~'I' f 'i, , ' , . . " ,~. '''I 11\,'-; " " , i i , I ~ i' , ' ' , ." 1 ~\ :, ,~~ ,. ,I ."', I I 1, Ii- .. _.' ~ ~" ,.J. .,t' "." i-.'ll ',' I " , f_. ," ',' '\ tfjll\' " - .1' i' '\~' , It i I .v.,;, '. I \~1 '- ~ , 1 'It((:__- \-,':\ 'c ,I' '\ i, I, '," III , i. -; .."t'.,.~ '1" _ .' "l'-' -J' '1, ," i I; -~,', - I -1)'\ "'i,I 'j . I~!/\ l \~~;-> ,_ .J ;'~1: !.' , ~_; 't > ji ",.- ,-,. ,', :/;1; '. J.il,!' . 1_, f; 1I . r ' '~'. .(" I'~J f.' "t\{ " _ " \! ':\r.'.I .\', 'I ';,.'1" ,\ ...,'" '~ "I " dJ; t _~I ~ _ ,;' ,'I!'~,. '" ~,I'!'('; ','_" -' .~,;~ " \' t -f' ; , , ~. . I I i, " "I' ."C'. f:.,j .: , ", 'I' I', ,,' . / , I 0/ 'I! " . \,1, ~O.1pO R~V, 0.00 IN nil: POURT PI' ooMMON P~FA!l DF q't1I111IQH';l\11 n cOUNTV, Pf,NN!lY~VANIA PPPI~f,T /I C)b> . PATIl f,NTFR~P b;} \ Ii) C\,IN) I' '\(1,'( I\'\ 'TO THf, PRP'TI1PNOTARV 01' {lAIP OOURTI PllfftllnnllllEllll1l1ol1 ~OP, 1 olll1p flpl1l1ftylvlll1ln UI1~l11rlpY111PI1I OQl11pol1ftllllol1 ~IlWI 4a p,a,!l ?PIl,'I, II1ls In II Qprtlllllll Qppy 01 1.11111 for IlI1p"llI 1ll10l11ployl11onl oomponnllllon llo 1111' IIn,IIo 11ft , InlllroQI pm! ppnlllllonlo' po Ill1loroll pI r0I111flllly yOIl" 1111 Imlpxoll "" 1llll00nonlQ pro Il1lloxocl, Pf,NNlW\-VANIA I=Mr~OYf,R AoaOUNT NUMI3f,RI 21-J.B1\26 8 ,\\q,LO 1,,1 'elll\ .!'if)6(,,[, vQI '-,(,>~'(nj POMMONWf.A\. TI'I OF Pf,NNElV~VANIA PIlPARTMf,NT OF \.AIlOR ANP INPU!lTRV , TO 'Tt1/i IJaf. OFTHl-1 UNIlMP~OVMl-1NT OOMflt:N!lATION FUNP QJ:RTIFII3P QOPY OF I.'~N Vftl . I'TlUI, IIT1l1lnS OOI1I'l\I1Y 1HO 1106 IUTlI3,Y HIl ,0TlMLISLI 1'1\ 17013 . " I ,I,: :il Ap NIH11110n tl76'70~ ' , ClTf'WR, co TRIDUTION . DUG PAIO/CReOIT 3-97 WE ,00 ,00 3-97 1,1103,14 ' ,00 1\-9'/ WE ',00 ,00 11-97 1,0915,48 ,00 1-913 WE ,00 ,00 1-98 1\131.,99 ,00 ., '11 L' ,Iii ~ : 1:.',1' ".,' BAlA oe ItHl'Of.L'f Ill/I!' OIl UN"^'O (lONIIUUUtltlN Mil: if nil ctllHnIllUTlut/I'"m l"'lI!. rJ!llA.lTYU' .. l"n: 'ItPolltl IU611ON0l1tll OIU!Cl: 14,46 , ,00 140,31 ,.00. 1.09,65 ,DO 1\13,20 ,00 1-,403,11\ ..00 1,096,1\0 .00 1101.,99 100,24 57,57 II, sUI1-lolnl 2 901. 61 Totnl ' r-lIlng Foo(o) I\dc\lllonal Leoni Oos\1l Aclcll\lonallnteros\ Bnllalno\1011'All1tJun\ '" Adcllllonallnlorosllb to bo oompulocl on 'he Abovo balnnOo 01 unpoillunomploymonl' oomp.nsallon QonlllbullonB 8\ Ih. rolo tlo\ormlhod I>y tho Soorewy of Rovonuq unclot Soollon 000 of tho FIBool 00110, 7a 1',0, D G06, por monlh, or fraollon of 0 monlh,from 00/31/19913 , Tnt undtf"bntd; Plftela', au/uu 61 Employ' I tllll OptlAlltlnt, OlpMmtnl 01 ~'''bOI find IndlJttty, ttt1lrlUlhM lht abov. untmployman\ uompanUllon conUlbutlOnt','inltt..ltM pantlllU t,. dut and P'y'blt b~ Ihl ..bO~t n'm,d atl'na.hl WHltl Ih, pro~I,loM ollha ronluylVAnlA lJntlTlpIO~fr'I'n\ Comptn'Atlon law. Pl,lftwt.nllo 8,~lfbn :)Oe,1 01 Uld L..w, "3 fl.B, , 18e.1, Ih. tbovt ~on\!lbl,l\lont', Inll!Ut And ptf1af1llt iI' !Ii litO upon IhtIIAflChl,,' .nd PloP'lli~1 bolh 'ta' Md PlltonAI, Inth,ldlnll Ahol iequU'd Pl()ptll~l (lllhlllbovt "Amlld dtrtndAnl iou AUACh Ih~l.tb rtotfllht dAlt 01 ,ntIY 011111, Otlllllld o~~~ or lI'n. ' R~~fn~M R, SCOT MlnORIOH 013/2ot 19913"",",-,, o Tn MII"lIhI blriCIQI, bur..u 01 Employ" nlCOrlllllUaM , 'fO IlB HB'l'lIIlmn IlY H1UCOllll1UGOI'l'ICIU