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IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, 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.
AD Number: 603029
CONTRIBUTIONS, INTEREST and/or LATE REPORT PENALTIES
DOCKET NUMBER: /p~- 1D9~~ Cif/l k°rI~
DATE ENTERED:
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
vs.
• GREATER HARRISBURG USBC
"Trading as"
GHUSBC
105 Slover Road
Mechanicsburg, PA 17055
QTR/
YEAR REPORT
STATUS CONTRIBUTION
TYPE CONTRIBUTION
DUE PAYMENTS/
CREDITS BALANCE
DUE INTEREST
DUE as of
70/25/2012 PENALTY
DUE TOTAL
DUE
1/2008 Filed Withholding $0.35 $0.35
112008 Filed Employer $296.96 $204.97 $91.99 $48.02 $140.01
212008 Filed Withholding $0.32 $0.32
2/2008 Filed Employer $296.96 $176.61 $120.35 $45.90 $166.25
3/2008 Amended Withholding $0.29 $0.29
3/2008 Amended Employer $296.96 $241.41 $55.55 $20.16 $75.71
4/2008 Amended Withholding $0.00 $0.00
1/2009 Filed Withholding $0.23 $0.23
112009 Filed Employer $296.96 $65.33 $231.63 $73.08 $304.71
2/2009 Filed Withholding $0.20 $0.20
2/2009 Filed Employer $296.96 $65.33 $231.63 $67.86 $288.48
3/2009 Amended Withholding $0.17 $017
312009 Amended Employer $296.96 $190.06 $106.90 $28.80 $135.70
4/2009 Amended Withholding $0.00 $0.00
1/2010 Filed Withholding $0.22 $0.22
1/2010 Filed Employer $309.96 $0.00 $309.96 $69.60 $379.56
2/2010 Filed Withholding $0.16 $0.16
2/2010 Filed Employer $309.96 $0.00 $309.96 $62.64 $372.60
3/2010 Amended Withholding $0.10 $0.10
312010 Amended Employer $324.84 $181.79 $143.05 $25.68 $168.73
4/2010 Amended Withholding $0.00 $0.00
1/2011 Filed Employer $347.55 $2.09 $345.46 $46.62 $392.08
2/2011 Filed Employer $347.55 $3.48 $344.07 $38.70 $382.77
3/2011 Filed Employer $103.07 $0.94 $102.13 $9.24 $111.37
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Auxiliary aids and services are available upon request to individuals with disabilities.
UC-7ZH REV 09-10 (page 2) Equal Opportunity Employer/Program
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QTR/
YEAR REPORT
STATUS CONTRIBUTION
TYPE CONTRIBUTION
DUE PAYMENTS/
CREDITS BALANCE
DUE INTEREST
DUE as of"
10/25!2012 PENALTY
DUE TOTAL
DUE
1/2012 Filed Employer $239.68 $2.40 $237.28 $10.68 $247,96
2/2012 Filed Employer $239.68 $2.40 $237.28 $5.34 $242.62
TOTAL
$3,421.60
'Unemployment compensation contributions bear interest at the rate ofone-twelfth Grand Total $3,421.60
(1/12) of the annual rate determined by the Secretary of Revenue under Section 806
of the Fiscal Code, 72 P.S. § 806, or at the rate of three quarters of one per centum Filing Fee(s) $21.50
(0.75%), whichever is greater, for each month or fraction of a month from the
date they are due through the date they are paid. Additional interest will accrue on the
above balance of unpaid contributions until they are paid.
The undersigned, Assistant Director, Office of Unemployment Compensation Tax Services, Department of Labor and Industry, certifies that
the above unemployment compensation contributions, interest and penalties are due and payable by the above named defendant under the
provisions of the Pennsylvania Unemployment Compensation Law. Pursuant to Section 308.1 of said Law, 43 P.S. § 788.1, the above
contributions, interest and penalties are a lien upon the franchises and property, both real and personal, including after acquired property, of
the above named defendant and attach thereto from the date of entry of this Certified Copy of Lien.
~~~ ~ ~ ASS ti
SALLY L. PIATAK 'lII ~ r ~a,ll''I III
Assistant Director, Office of Unemployment Compensation Tax Service UC-72820121026113831133959752203
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uepartment or Labor & Industry i Office of UC Tax Services ~ 651 Boas Street ~ Harrisburg, PA 17121-0750 ~ www.dli.state pa us
Auxiliary aids and services are available upon request to individuals with disabilities.
UC-728 REV 09-10 (page 3) Equal Opportunity Employer/Program