HomeMy WebLinkAbout01-05556UC-728 REV. 6-98 ~~ _ ~~~/ /~(,' ,-, n
DOCKET #
IN THE COURT OF COMMON PLEAS OF
COUNTY, PENNSYLVANIA
CUMBERLAND
DATE ENTERED
~~
CERTIFIED COPY OF LIEN COMMONWEALTH ENNSYLVANIA
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 vs.
Pennsylvania Unemployment ~
Compensation Law, 43 P.S. § 788.7, TOBY L COY
t~ ~-
~~
thisisaCertifiedCopyofLienfor INDIVIDllALLY & T/A C ~ -f
unpaid unemployment compensation DON COY ~ S GARAGE ~ ~_, r~ - -
COMribntlOnS,interest andpenaltieStO SOUTH EARL ST EXTD ~- ,~ _ _:
be entered of record by you and SHIPPENSBURG PA 17257~~ u. _ ~%
indexed as judgments are indexed. •
~•
~= ='
%--
PENNSYLVANIA EMPLOYER - ~~`~'
ACCOUNT NUMBER: 21-18877 8 t.3
~ rv
AD Number: 291585
C!TR/YR. CONTRIBUTION INTEpEBT OVE ON UNPAID PENALTY UUE -
0
DUE PAID/CREDIT BALANCE CONTgIBUTION PAIO LATE. pIBHONOPE0
CHECK
3-00 WE .00 .00 .00 .00
3-00 496.94 .00 496.94 40.17 49.69
4-00 WE .00 .00 .00 .00
4-00 331.30 .00 331.30 19.88 33.13
sub-total
dditional interest is to be computed on the above balance of unpaid unemployment Filing Fee(s) 9 . 0 0
ompensation contributions at the rate determined by the Secretary of Revenue ~.'itlOrl~ll_~aB.~jal g ~ ~' ~~ ~~
nder Section 806 of the Fiscal Code, 72 P.S. fi 808, per month, or fraction of a gddltional I riteresY
fonth,from 09/30/2001
3atls€a~fttt7 A~m~tfant
The underelgned, Dlredor, Bureau of Employer Tex Oparatlons, Depanment of Labor antl Industry, cenlAas that the above unemployment compensation comributiona, Interest and pertaNlea
are due and payable by the above named defendant under the provisions of the Pennaylvanle Unemployment Compenaetlon Law. PunuaM to Section 308.1 of Bald Lew, 43 P.B. § 768.7,
iha above contdbutlons, Intoreat end penelllas ere a Ilan upon the frahchisas and property, both reel end penonal, Including after acquired property, of the above named defendant and
attach thereto from the date of emry of thla Certlfletl Copy of Llen.
~'~~~,
09/06/2001
DATE
R. SCOT MIEDRICH
Aealatam Director, Bureau of Employer TeK Opantlons
TO BE RETATN'ED BY RECORDING O'r'EICE
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