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03-5558
IN THE COURT OF COMMON PLEAS OF DOCKET # O.~- CUMBERLAND COUNTY, PENNSYLVANIA DATE ENTERED CERTIFIED COPY OF LIEN TO THE PROTHONOTARY OF SAID COURT: .~Oa.. l)~,~' ~ Iq.Co Pursuant to 43 P.S. § § 874(a) and 788.1, this is a Certified Copy of Lien for overpaid unemployment compensation benefits and interest to be entered of record by you and indexed as judllments are indexed. Social Security Account Number: 210-44-7265 Job Center #: 0996 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF LABOR AND INDUSTRY TO THE USE OF THE UNEMPLOYMENT COMPENSATION FUND VS. MERVIN E. GLENN 32 CENTER STREET # 37 MOUNT HOLLY SPRINGS, PA. 17065 claim Week Overpaid Claim Week Overpaid Ending Date Amount Ending Date Amount Claim Week Overpaid Claim Week Ending Date Amount Ending Date Overpaid 01-10-98 $273.00 01-17-98 $13.00 01-24-98 $97.00 01-31-98 $13.00 02-28-98 $62.00 03.07-98 S354.00 03-14-98 S354.00 03o21-98 $354.00 03-28-98 $354.00 04-04-98 $354.00 04-11-98 $354.00 04-18-98 $354,00 04-25-98 S354.00 05-02-98 S354.00 05-09-98 $354.00 Additional interest vail accrue on the balance due of the above overpaid unemployment compensation benefits after 09-30-03 For the total amount due on this lien, phone (717) 783-3140. Total'Overpaid Amount Minus Amount Repaid Plus Interest .... $1 Z85. ZZ ota, . ....:..:':'..:.'.." ' Filing Fee $14.00 The undersigned, Assistant Director, Bureau of Unemployment Compensation Benefits and Allowances, Department of Labor and Industry of the Commonwealth of Pennsylvania, certifies that the above parson is obligated, pursuant to 43 P.S. § 874(a) to repay the above overpaid unemployment compensation benefits received by him/her together with interest thereon, charged per month or fraction of a month, beginning fifteen (15) days after the Notice of Overpayment was issued and continuing until the overpaid benefits are repaid. The interest rate is determined by the Secretary of Revenue as providedbySectiong06oftheFisca[Code. Inaccordancew~th43 p.S. § § 874(a) and ?88.1, the above overpaid unemp[oyment compensation benefits and interest are a lien upon the franchises and property, both rea[ and persona[, including after-acquired property, of the above person and attach thereto from the date of entry of this Certified Copy of Lien. October 10, 2003 ~ng Chief of Ul Claims Ser'~ces Date mmm © OZ u.O 0o r~ 0 0 Z ~ ,,m o ~ <O~Z ~zO~ O~ ~ ~Z