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UC.728 REV. 6.98
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CK It CD 1000
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
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CUM8i:Hl~i!D COUNW
PENNSYLVANLb~
CERTIFIED COpy OF LIEN
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
Pennsylvania Unemployment
Compensation Law, 43 P.S.!i 788.1,
this is a Certified Copy of Lien for
unpaid unemployment compensation
contributions, interest and penalties to
be entered of record by YOll and
indexed as judgments are indexed.
.
vs.
BODY TYME INC
457 WOLF'S BRIDGE ROAD
CARLISLE PA 17013
.
PENNSYLVANIA EMPLOYER
ACCOUNT NUMBER: 21-16844 0
AD Number:
286143
aTRlYA.
DUE
CONTRIBUTION
PAID/CREDIT
BALANCE
INTEREST DUE ON UNPAID
CONTRIBUTION AND I OR
CONTRIBUTION PAID LATE.
PENALTY DUE -
LATE REPORTI
DISHONORED CHECK
2-99 WE
2-99
3-99 WE
3-99
.00
231.45
.00
289.97
.00
.00
.00
.00
.00
231.45
.00
289.97
19.09
.00
.00
.00
.00
18.85
sub-total
Additional interest is to be computed on tl18 above balance of unpaid unemployment
compensation contributions at the rate determined by the Secretary of Revenue
under Section 806 of the Flscai Code, 72 P.S. g 806, per month, or fraction of a
month, from 08/31/2000 .
Additional Interest
The undersigned, Director, Bureau of Employer Tax 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 Section 30a,1 of said Law, 43 P.B. fj 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.
RJut1f1~
R. SCOT MIEDRICH
08/04/2000
DATE
Assistant Director, Bureau of Employer Tax Operations
TO BE RETAINED BY RECORDING OFFICE
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