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12-3987
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CERTIFIED COPY OF LIEN TO THE PROTHONOTARY OF SAID COURT: Pursuant to 43 P.S. 3 5 874(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 judgments are indexed. Social Security Account Number: XXX-XX-4119 Job Center # 0996 Claim Week Ending Date Overpaid Amount 10/15/05 $206.00 10/22/06 $206.00 10/29/06 $206.00 11/05/05 $206.00 11/12/05 $206.00 Claim Week Overpaid Ending Date Amount Additional interest will accrue on the balance due of the above overpaid unemployment compensation benefits after 05/31/12. For the total amount due on this lien, phone (717) 783-3140. DOCKET # ?a - 398 0I0 l?n' DATE ENTERED: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF LABOR AND INDUSTRY TO THE USE OF THE UNEMPLOYMENT COMPENSATION DF% D w VS. --1 ` KWAJALYN T JACKSON 2001 RUPLEY RD APT 108 CAMP HILL, PA 17011 3? z "*? .4 o Claim Week Overpaid Ending Date Amount Claim Week Overpaid Ending Date Amount Total Overpaid Amount $1,030.00 Minus Amount Repaid $315.00 Principal Balance Due $715.00 Plus Interest $421.04 Total Due $1,136.04 Filing Fee $21.50 The undersigned, Director, Bureau of Unemployment Compensation Benefits and Allowances, Department of Labor and Industry of the Commonwealth of Pennsylvania, certifies that the above person is obligated, pursuant to 43 P.S. 5 874(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 provided by Section 806 of the Fiscal Code. In accordance with 43 P.S. S S 874(a) and 788.1, the above overpaid unemployment compensation benefits and interest are a lien upon the franchises and property, both real and personal, including after-acquired property, of the above person and attach thereto from the date of entry of this Certified Copy of Lien. '4 a1.50 POPtFF 0 it '1339.- June 1, 2012 a77/5y Director, Bureau of Unemployment Compensation Benefits and Allowances Date 0 0 0 0 ?I co c do m 0 co O m m A z 0 m 0 0 C7 z` 0 m k a, ZI 4 rn ten, a J ?c j rb rb t4 O a 3 3 c y 4 N' a ro D .C) C 0) O 0 O co s cn' v CD Q m 0 CD a 0 CD Q a N Cl) Cl) N a) CA C CD Q o ` G wow A' (D CO Co ?" mcD3 Cl) v' v N O O :-? ? ,a -n 0 ti CD 0 co CD CD m m z ? O-<- r- M ,> z p0 A C :jZ0 z m ? ? < zm -i x rn°© 0 -, - D 0 p ro o cn O o 0 c C O d -4 cr ty' Im CD a 3 -.9 CD ?ocr a?co ccs< C) n- Q- < a cr :3 Ca M &- a) C 7. a CL O O O x (D 3 CD ?ap O it 3 :7- 9 = 00- CD ? o 0 - '-? fD OL CD .a cr --+ --j u ? CD O cl) O -p `C R 0+ g 2. R A 3 ?a.cQo Cl) b .+ o o LU ?.O c'n O Q cn m; R x Ch a -t CD (D ? O CD (D c y rn CD ,. 3 C?0 _ a 6 O1 ? 0 .r rn? 0 ?' O -.n rn*< , CD x c r C: n CD M 6r n 0 m < = N' CL Q 0 O N Cn' m N C.) a C OL "a 0 CL CD CD v -D CD CD ? CD C2 CD C Z o? M m0 O ?p K0m? rn?Zm CnC n pO O Z'n ju m b Z --q 20 z 0 md? c _z o ?D D p O m z Xl m f G o+ z( C ZZ r D <cn z O -n D