HomeMy WebLinkAbout03-4799UC-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: 21-17637 0
AD Number: 301738
DOCKET# O~-
DATE ENTERED
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
va.
FLYING J INC
PO BOX 150310
OGDEN UT 84415
CONTRIBUTION INTEREST DUE ON tJNPAIO PENALTY DUE -
QTR/YR. CONTRIBUTION AND ! OR LATE REPORT/
DUE PAID/CREDIT BALANCE CONTRIBUTION PAID LATE. DISHONORED CHECK
3-01 WE .00 .00 .00 .00
3-01 17,400.98 17,400.98 · 00 .00 .00
3-01 MP 250.00
1-03 WE 279.57 279.57 .00 .00
1-03 40,613.92 40,334.35 279.57 4.66 .00
sub-total
279. 57 4.66 250.00
Additional 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. § 806, per month, or fraction of a
month, from 08/31/2003
Filing Fee(s)
Additional Interest
14.00
SALLY L. FUHRER
A~$1st~nt Director, Bureau of Emr~loyer T&x Operations
TO BE RETAINED BY
RECORDING OFFICE
08/27/2003
DATE
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