HomeMy WebLinkAbout04-0875UC-728 REV. 9-03
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
~ ~qlq l~-c.. I7
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: 21-22108 2
DOCKET # ~¥- ??~'
DATE ENTERED
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
VS.
THE FINANCIAL COACH INC
128 W MAIN ST
MECHANICSBURG PA 17055
AD Number: 304627 ~
CONTRIBUTION ~.TE.ESTOUEO. UN.^,~ .~.~T~U~-
QTR/YR, CONTRIBUTION AND / OR rATE REPORT/
DUE PAI~CREDIT BA~NCE CONTRIBUT~ONPAIDLATE. DISHONOREDCHECK
2-03 WE 5.44 5.44 .00 .00
2-03 983.16 491.21 491.95 13.53 .00
3-03 WE 5.90 .00 5.90 .00
3-03 877.91 .00 877.91 13.26 88.38
4-03 WE 12.54 .00 12.54 .00
4-03 941.79 .00 941.79 3.18 .00
sub-total 2,330.09
29.97 88.38
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 02/28/2004
Filing Fee(s)
Additional Interest
14.00
The underslBned, Assistant OIrector, Bureau of Employer Tax Operations, Depa~ment of Labor and Industry, certifies that the above unemploy~nent compensation contributions, Iht ernst and
SALLY L, FUHRER
Aspirant Director, Bureau of Employer T~x Opere. tions
TO BE RETAINED BY
RECORDING OFFICE
02/12/2004
DATE
Z