HomeMy WebLinkAbout03-4793UC-728 REV, 8-03
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, 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: 21-16989 7
AD Number: 301733
QTR/YR.
1-03 WE
1-03
DUE
63.80
745.92
CONTR)BUTION
PAID/CREDIT
DOCKET # 03 - ?793
DATE ENTERED
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
BLUE MOUNTAIN ANESTHESIA
ASSOCIATES PC
246 PARKER ST
CARLISLE PA 17013
.00
.00
BA~NCE
63.80
745,92
INTEREST 0UE ON UNPAID
CONTRIBUTION AND / OR
CONTRIBUTION PAID LATE.
13.49
PENALTY DUE -
LATE REPORT/
DISHONORED CHECK
.00
.00
sub-total
809.72 13.49 .0(
Additional interest is to be computed on the above balance of unpaid unemployment FIlJF 14.00
compeneation contributions at the rate determined by the Secretary of Revenue
under Section 806 of the Fiscal Code, 72 P.S, § 806, per month, or fraction of a Additional Interest
month,from 08/31/2003
SALLY L. FUHRER
BY RECORDING OFFICE
08/27/2003
DATE
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IN THE cOURT OF cOMMON PLEAS OF CUMBERLAND
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
to the use of the
UNEMPLOYMENT COMPENSATION FUND
VS.
BLUE MouNTAIN ANESTHESIA
ASSOCIATES PC
246 PARKER ST
CARLISLE PA 17013
cOUNTY, PENNSYLVANIA
DOCKET NUMBER 03 4793 CIV
AUTHORITY TO REMOVE LIEN
TO THE PROTHONOTARY OF SAID COURT:
NOW, to wit, JULY 27, 2004 , the Commonwealth of Pennsylvania,
Department of Labor and IndustrY, to the use of the Unemployment Compensation Fund,
Plaintiff in above action, through its Chief Counsel, by its ,Assistant Counsel, desires that the
above captioned lien be removed from record.
AND you, the Prothonotary of said Court, are hereby authorized and empowered, in
the name and stead of the Plaintiff, to remove said lien from the record as fully and.
effectually, to all intents and purposes, as we could were we present in person to do so: and
for so doing, this shall be your sufficient warrant of authority.
IN TESTIMONY WHEREOF; there is hereunto affixed the Seal of the Department of
Labor and Industry, Commonwealth of Pennsylvania, this 27 TH day of JULY , 2004.
ACCOUNT NO. 21-16989
AD NO. 301733
~.~
SEAN F.
Deputy Chief Counsel For Employment Security