HomeMy WebLinkAbout03-3492UC-728 REV. 6-98
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
DOCKET #02
DATE ENTERED
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: 21-22038 8
AD Number: 3008z;8
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
VS.
BURK INTERNATIONAL
STE 203
3438 TRINDLE RD
CAMP HILL PA 1701~('~
QTP,/YR. CONTRIBUTION INTERESTDUEONUNPAID PENALTYDUE-
CONTRIBUTION AND / OR LATE REPORT/
DUE PAID/CREDIT BA~NCE CONTRIBUTIONPAIDLATE, DISHONOREDCHECK
3-02 WE .00 .00 .00 .00
3-02 748.75 .00 748.75 29.32 74.88
4-02 WE .00 .00 .00 .00
4-02 1,273.38 .00 1,273.38 31.83 .00
sub-total
2,022. 13 61. 15 74.88
Additional interest is to be computed on the above balance of unpdd unemployment FIIIn~ Fee(s) 1 4.0 0 '
compensation contributions at the rate determined by the Secretary of Revenue ~j6~i~: [~ : ::i::: ::i:: ::
under Section 806 of the Fiscal Code, 72 P.S, § 806, per month, or fraction of a Additional Interest
month, from 0 7 / 3 1 / 20 0 3
R. SCOT MIEDR[CH
AsBl~tant Director, Bure&u of Employer Tax Operations
TO BE RETAINED
BY RECORDING OFFICE
07/01/2003
DATE
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