HomeMy WebLinkAbout01-04436- ~~ ~'
UC-728 REV. 6-98
~~Il~l~~(es
IN THE COURT OF COMMON PLEAS OF
cuMBERLANDCOUNTY,PENNSYLVANIA `
CERTIFIED COPY OF LIEN
TO THE PROTHONOTARY OF SAID COURT:
Pursuant to Section 308.1 of the
Pennsylvania Unemployment
Compensation Law, 43 P.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.
PENNSYLVANIA EMPLOYER
ACCOUNT NUMBER: 21-18053 &
AD Number: 290459
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DOCKET #
DATE ENTERED
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
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JFK-T GROUP
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T/A KOSTA'S '' _
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CAMP HILL P A 17011_ ~
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OTR/YR CONTRIBUTION INTERE3T OUE ON UNPAID
CONTRIBUTION ANO / OR PENALTY OUE -
LATE REPORT/
. DUE PAIDICREDIT BALANCE CONTRIBUTION PAID LATE. 013HONOREO CHECK
4-99 WE .00 .00 .00 .00
4-99 713.27 713.27 .00 4.75 64.34
4-99 CP ~ 64.34
400 WE .00 .00 •00 .00
400 695.22 .00 695.22 31.28 .00
101 WE .00 .00 .UO .00
101 789.33 .00 769.33 17.76 .00
sub-total
j Additional interest is to be computed on the above balance of unpaid unemployment rlling tee(s)
?- compensation contributions at the rate determined by the Secretary of Revenue Ai{Clltjf1T181 j„ ;~~_
? under Section 806 of the Fiscal Code, 72 F.S. § 806, per month, or fraction of a Additional Interest
month, from 07 31/2001
/ ~,t8t3~e1C'.~IDr1.Art5Yi1 E13
The underalgned, Dlroctor, Bureau of Employer Tax Operatlona, DepedmeM of Labor and Industry, eertlfles that the above unemployment eompenaetlon coniributlona, Imarast and peneldee
ere due end payable by tho above named defendant under iha provlslona oP the Pannaylvehle Unemployment Compenaetlon Low, Purouanl to Secllon 303.1 oP seld Law, 43 P.S 5 78a 1,
the eoove cantributlans, Intaree! end peneltles ere a Ilan upon the frenehlaea and property, both reel and personal, Including after acquired property, of the above named defendant end
eaech thereto from the date of entry of this Certlfled Copy of Llen.
~~~~~~
R. SCOT MIEDRICH 0 7/ 0 5/ 2 0 01
DATE
Asslstenl Director, Bureau of Employer Taz Operations
TO BE RETAINED BY RECORDING OFFICE
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