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UC.728 REV, 6-98
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IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
f?FF /65103
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DOCKET # rqJIt-(YlK:;f:
DATE ENT.it\-Ed' ... <'i\1OTARY
OOOEe 13 PN 3: 32
CUMi:3ERLA\JO COUNiY
COMMONWEALTH OF PENNSYL~.&YLVAflJlA
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
CERTIFIED COPY OF LIEN
TO THE PROTHONOTARY OF SAID COURT:
Pursuant to Section 308.1 of the
Penn~ylvania Unemployment
Compens/ltion 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 you and
indexed as judgments are indexed,
vs.
.
CHARLES R GEROW
4725 CHARLES ROAD
MECHAN~CSBURG FA 17055
.
PENNSYLVANIA EMPLOYER
ACCOUNT NUMBER: 21-20749 7
H
AD Number:
287629
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QTRlYR, CONTRIBUTION INTEREST DUE ON UNPAID PENAL TV DUE -
CONTRIBUTION AND! DR LATE REPORT!
DUE PAID/CREDIT BALANCE CONTRIBUTION PAID LATE. DISHONORED CHECK
2-96 I
WE .63 .00 .63 .00 I
2-96 76.95 .00 76.95 28.00 .00
3-96 WE 1. 37 .00 1. 37 .00
3-96 166.73 .00 166.73 56.87 .00 I
4-96 WE 1. 26 .00 1. 26 .00
4-96 49.47 .00 49.47 16.02 .00
1-97 WE .00 .00 .00 .00
1-97 171. 50 .00 171.50 50.31 .00
2-97 WE .00 .00 .00 .00
2-97 108.50 .00 108.50 29.39 .00
I sub-total 576.41 180.59 .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 of the Fisoal Code, 72 P,S, ~ 806, per month, or fraction 01 a
month,lrom 11/30/2000 .
....... ... ..... ....,.. ... ...... ,it .... ,.,.,..,.".",.",.,.".",.,.,.".",.".".,.,.,.".,.".,.,'.'!t!lf!t'."tlt:('.,.,
; ,'.........m..........bl..'..'...'..'."'.'............. ii1t1.,....,.....1.....................'.f.....,.'...f.....'..'...'...............9'.............'...f.,0..>..'.0.....;.......1
. - - .. . - . . .,....,.','.',.............;.'...:.,.;.,.;.,.:.,.,':',':.:':. ~
Filing Fee(s) .. .........,............,................, "
~~ft!M~!gg!_~II;Ii I
Additional I nterest
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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 payabll! by the above named defendant under the provisions of the Pennsylvania Unemployment Oompensatlon Law. Pursuant to Section 308.1 of said Law, 43 P,S, ~ 788.1,
the above contrlbutltlns, 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 Oertlfled Copy of Lien.
mi.!j
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RJut~~
A. SCOT MIEDAICH
11/27/2000
DATE
Asslstant Director, Bureau of Employer Tax Operations
TO BE RETAINED BY RECORDING OFFICE
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR & INDUSTRY
to the use of the
UNEMPWYMENT COMPENSATION FUND
Docket Number 00 8604 CIV
vs.
CHARLES R GEROW
4725 CHARLES ROAD
MECHANICSBURG PA 17055
AUTHORITY TO SATISFY
TO THE PROTHONOTARY OF SAID COURT:
NOW, to wit, JANUARY 19, 2001 the Commonwealth of Pennsylvania,
Department of Labor and Industry, to the use of the Unemployment Compensation Fund,
Plaintiff in the above action, through its Chief Counsel, by its Deputy Chief Counsel for
Employment Security, acknowledges having received of the Defendant above named full
payment and satisfaction of the above captioned Lien, with 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 intents and purposes,
as we could were we present in person to do so; and for so doing, this shall be your
sufficient warrant of authority.
IN TESTIMONY WHEREOF, there is hereunto affixed the Seal of the Department of
Labor and Industry, Commonwealth of Pennsylvania, this 19 TH day of JANUARY , 2001.
ACCOUNT NO. 21-20749
AD NO. 287629
~ ~ e.~...~
SEAN F. CREEG
Deputy Chief Counsel for Employment Security
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