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UC-728 REV, 6.98
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IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
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DATE ENTERED
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CERTIFIED COPY OF LIEN
COMMONWEALTH OF PENNSYLVANIA
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
Pennsylvania Unemployment
Compensation Law, 43 P .S. 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.
vs.
.
Melissa G. Stuart
. bdivideal1y & T/A
The Boli Factory
261 Deerfie1d Road
.CampHill,PA 17011
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PENNSYLVANIA EMPLOYER.
ACCOUNT NUMBl:R: 21-20193-6
AD Number: 50 i5:3 (
QTRlYR. CONTRIBUTION INTEREST DUE ON UNPAID PENALTY DUE -
DUE PAID/CREDIT CONTRIBUTION AND! OR LATE REPORT!
BALANCE CONTR1BUT10N PAlO LA.TE. 01SHONOREO CHECK
3/99AS 413.02 413.02 77.10 41.30
4/99AS 669.49 669.49 1l2.70 66.95
1/00AS 498.60 498.60 73.96 49.87
2/00AS 332.40 443.40 42.66 33.24
I sub-total 1,913.51 306.42 191.36
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Filing Fee(s)
5l:1!JIl!P!l~!j.!W:9i~.I!................
Additional Interest
$~~!!lf~iitrgQAml:!!lilt ;n;!,....... .....,...............
Additional interest Is to be computed on the above balance of unpaid unemployment
compensation contrlbutlonsatt~e rate determined by the Secretary of Revenue
under Section 80e of the Fiscal Code, 72 P.S. 6 806, per month, or fraction of a
month, from 01/31/02
The undersI9~ed, Director, Bureau of Employer Tax Operations, Department of Labor and Industry, certifies that 1he above u,nemploymen1 e'ompensallon eontrlbullons, Interest and penalties
are due and"payable by the above named defendant under the provisions of the Pennsylvania Unemployment Compensation Law. Pursuant to Section, 308.1 of said Law, 43 P.S. i 788.1,
1he 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
allach thereto from the date of entry of this Certified Copy of Lien.
R Juit1?1~
R SCOT MIEORICH
12/17/01
DATE
Assistant Director, Bureau of Employer Tax Operations
TO BE RETAINED BY RECORDING OFFICE
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