HomeMy WebLinkAbout01-2478UC-728 REV, 6-98
CUEBg~gA~D COUNt, 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: 21-19755 6
AD Number: 289016
QTFYYR
DUE
4-99 WE .00
4-99 50.10
CONTRIBUTION
PAID/CREDIT
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
vs.
NORTH ATLANTIC COFFEE & TEA INC
T/A NORTH ATLANTIC COFFEE COMPANY
3800 TRINDLE ROAD
CAMP HILL PA 17011
INTEREST DUE ON UNPAID pENALTY DUE -
CONTRIBUTION AND / OR LATE REPORT/
BALANCE CONTRIBUTION pAID LATE, DISHONORED CHECK
.00 .00 .00
.00 50.10 4.80 .00
I 50.10 4.80 .00
sub-totsl
Iditional Interest iBrD be computed on the above balance of unpaid unemployment Filing Fee(s) 9.00
contributions at the rata determined by tha Secretary of Revenue i::~':. ===================================================================================================================================
,mpensatlon
dBr Section 806 of the Fiscal CodB, 72 P.S. § 806, per month, or fraction of a AddEIonal Imerest
o / / o o ·
~e undersigned, DlreMor, Bureau ~ Empl~er T~ Operatlon~, Depa~me~t ~ Labor a~d InduM~, ¢e~lfles that the above unempl~ment compeneMIon ¢o~rlbutlons, Intere~ and
are due and p~able by the ~ove named d~enda~ under the pr~alons ~ che PennsylvaDia Unemployment Com~ens~lon L~. Pursu~ to Ballon 308.1 ~ said ~, 43 P.S. ~ 788,1,
R, SCOT MIEDR~CH 0 3 / 2 2 / 2 0 0
DATE
TO BE RETAINED BY RECORDING OFF[CE
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