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UC-728 REV. 6-98
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
DOCKET #Q:)-'1'1.5&' &;.p
DATE ENTERED
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 of the
Pennsylvania Unemployment
Compensation Law, 43 P.S. 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.
vs.
.
KENNETH G BURRY
INDIVIDUALLY & T/A
KEN'S ELECTRIC
401 PINE ROAD
MT HOLLY SPRINGS
.
AD Number:
287363
1.(.00
BALANCE
.00 .00
.00 20.87 25.00
.00 .00
.00 28.35 25.00
.00 .00
.00 57.42 27.42
.00 .00
23.91 43.67 25.00
.00 .00
166.49 30.11 25.00
.00 .00
140.61 22.26 25.00
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PENNSYLVANIA EMPLOYER
ACCOUNT NUMBER: 21-18769 0
QTRlYR. CONTRIBUTION
DUE PAID/CREDIT
1-96 WE .47 .47
1-96 56.96 56.96
3-96 WE .72 .72
3-96 88.32 88.32
4-97 WE .00 .00
4-97 274.24 274.24
1-98 WE .00 .00
1-98 228.20 204.29
2-98 WE .00 .00
2-98 166.49 .00
3-98 WE .00 .00
3-98 140.61 .00
sub-total
Additional Interest Is to be computed on the above balance of unpaid unemployment
compensation contribulions al the rale delermlned by Ihe Secretary of Revenue
under Section 806 of the Fiscal Code, 72 P,S, 6806, per month, or fraction of a
monlh, from 11/30/2000 .
'::,:,,:lmlii'
Filing Fee(s)
"15jjl!~~~~~!~~~~,:'IIr:"I'Jl"""""""""""","
$@!!![@~!pqil!!lgijl,'I'.'.'......
331.01 202.68
,i'llrR~~~~g:r
152.42
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............."".
...................
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:::::::::::::::::::::::::::::::;::;:
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The undersigned, DIrector, Bureau of Employer Tax OperatIons, Department of Labor and Industry, certifIes that the above unemploYment compensation contrlbullons, Interest and penames
are due and payable by the above named defendant under the provisions of the Pennsylvania Unemployment Compensation Law. Pursuant to Section 308.1 of said Law, 43 P.S. i 788.1,
the above contributions, Interest and penalties are a lien upon the franchises and properly, both real and personal, Including after acquired properly, of the above nam.d defendant and
attach thereto from the date of entry of this Certified Copy of Lien.
R Jut1f1~
R SCOT MIEDRICH
11/08/2000
DATE
Assistant DirectOr, Bureau of Employer Tax Operations
TO BE RETAINED BY RECORDING OFFICE
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