HomeMy WebLinkAbout04-4710UC-728 REV. 4-04
IN THE COURT OF COMMON PLEAS OF
CUMBERnAND COUNTY, PENNSYLVANIA
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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: 21-20874. 4.
AD Number: 307877
QTR/YR.
DUE
1-0~ ~ 4.07.94.
1-0~ 11,216.15
CONTRIBUTION
PAID/CREDIT
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DOCKET.//' O~/· q?lo ~c~
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DATE ENTERED
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
VS.
HEALTHC0RE LLC
47 W POMFRET ST
CARLISLE PA 17013
BA~NCE
407.94
11,216.15
INTEREST DOE ON UNPAID PENALTY DUE
CONTRIBUTION AND / OR LATE REPORT
CONTRrSUTION PAID LATE DISHONORED CH
193.72
sub-total
11,624.09 193.72
· ¢lditional interest is to be oomputed on the above balanoe of unpaid unemployment Filing Fee(s) 14.0 0
compensation contributions at the rate determined by the Ssoretary of Revenue
coder Section 806 of the Fiscal Code, 72 P.S. § 806, per month, or fraction of a Additional Interest
,.onth, ~ro., o 8 / 3 o / 2 o o 4.
The undersigned, Aesl~tent Director, Office of Unemployment Compensation Tax Sere[cee, Department of Labor and Industn;'~ certifies that the above unemployment compensation
¢ontrlbution~, Interest &nd penalties ere due e. nd payable by the above named datend~,rlt under the provisions of the Pennsylvanle Unemployment Compensation Law. Pursuant to Section
308.1 of said Law, 43 P.S. § 788.1, the above ¢ontrlbutione~ fntereat and penalties are a lien upon the franchises and properbJ, both real and personal, including after acquired propeffy~ of
the above named defendant and attach thereto from the date of ent~ of this Ced~fied Copy of Lien.
SALLY L. FUHRER
Assistant Dlrector~ Office of Unemployment Compensation Tax Selvices
TO BE RETAINED BY RECORDING
OFFICE
09/03/2004
DATE
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