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165
IN.THE COURT OF COMMON PLEAS OF
Cumberland COUNTY, PENNSYLVANIA
CERTIFIED COpy OF lIE'N
TO THE PROTHONOTARY OF SAID COURT:
PurSuant to 43 P.S. !i !i. 874 (a) and 788.1, this is a
Certified Copy of lien for overpaid unemployment
compensation benefits and interest to be entered
of record by you and indexed as judgments are
indexed.
Social Security Account Number: 178-58-4792
Job Center #: 0996
Claim Week OVerpaid
Ending Date Amount
05-04-96 295.00
05-11-96 295.00
05-18-96 295.00
05-25-96 295.00
06-01-96 295.00
06-08-96 295.00
06-15-96 295.00
"
Claim Week Overpaid
Ending Date Amount
,
,
,
Additional interest wm accrue on the balance due of the
. above overpaid unemployment compensation benefits
after 2/28/2001. For the total amount due on
this lien, phone (717) 787-4765.
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DOCKET #
DATE ENTERED
. (~p.~ ~~HJ'
COMMONWEALTH OF9PE!NNSYL VANIA:
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
vs.
Daniel R, Marcinkowski
1550 Williams Grove Lot 136
Mechanicsburg, Pa, 17055
{!;J!.. (P 0 "3 'J-()
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Claim Week
Ending Date
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Overpaid
~~ Amount
Overpaid
Amount
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Minus Amount Repaid C:165.00
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Plus Interest
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Filing Fee
The undersigned, Assistant Director, Bureau of Unemployment. Compensation Benefits and Allowances, Department of labor and Industry of. the
Commonwealth of Pennsylvania, certifies that the above person is obligatedl pursuant to 43 P.S. S 874(a) to repay the above overpaid unemployment
compensation benefits received by him/her together with interest thereon, charged per month or fraction of a monthl beginning fifteen (15) days after the
Notice of Overpayment was issued and continuing until the overpaid benefits are repaid. The interest rate is determined by the Secretary of Revenue as
provided by Section 806 of the Fiscal Code. In accordance with 43 P.S. S 5 874(a) and 788.1, the above overpaid unemployment.compensation benefits and
interest are a lien upon the franchises and propertyl both real and personall including after-acquired property, of the above person and attach thereto from
the date of entry of this Certified Copy of Lien. .
~~~~.~
N\arch 12. 2001
Date
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