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UC.728 REV. 6.98
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
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CERTIFIED COpy OF LIEN
DOCKET # 0/- ~3'{/
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DATE ENTERED
TO THE PROTHONOTARY OF SAID COURT:
Pursuant to Section 308.1 of the
Pennsylvania Unemployment
Compensation Law, 43 P.S. i 788.1,
thill 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.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
vs.
.
COURTEOUS RENTAL
50 MARKET STREET
LEIWYNE FA 17043
INC
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PENNSYLVANIA EMPLOYER
ACCOUNT NUMBER: 21-17617 6
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AD Number:
292370
QTRlYR.
DUE
CONTRIBUTION
PAID/CREDIT
BALANCE
INTEREST DUE ON l)NPAID
CONTRIBUTION AND I OR
CONTRIBUnON PAID LATE.
PENAL TV DUE
LATE REPORTI
DISHONORED CHECK
1-01 WE
1-01
2-01 WE
2-01
.00
3,908.97
.00
3,790.60
.00
.00
.00
.00
.00
3,908.97
.00
3,790.60
175.90
85.29
.00
250.00
.00
250.00
sub-total
dditional 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 Fiscal Code, 72 P.S. ij 806, per month, or fraction of a
onl'n,lrom 10/31/2001
TM 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 payable by the above named defendant under the provisions of the Pennsylvania Unemployment Compensation Law. Pursuant to Seetlon 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 named defendant and
athlch thereto from the date of entry of thIs Certltled Copy of Uen.
RJut?J1~
R. SCOT MIEDRICH
10/24/2001
DATE
Assistant Director, Bureau 01' EmployerTax Operations
TO BE RETAINED BY RECORDING OFFICE
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