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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: 602034 CONTRIBUTIONS. INTEREST and/or LATE REPORT PENALTIES DOCKET NUMBER: la ~ (~qar]' Ctvf~Tpa'1'K DATE ENTERED: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF LABOR AND INDUSTRY TO THE USE OF THE UNEMPLOYMENT COMPENSATION FUND vs. : ~ ~ THE TREEHOUSE KID'S~LUF~a :~~ ~ K.; 301 South Penn Street~w © I"'~~=- Shippensburg, PA 172~~ -~ ~~ Z f-- ..- ~~" ~ ~ c.~ T7 r, ~ Z +"~'~ ~r ~ ; ~'; N ~' ~ r ~ v ~ ..t. ~''~ QTR/ YEAR REPORT STATUS CONTRIBUTION TYPE CONTRIBUTION DUE PAYMENTS! CREDITS BALANCE DUE INTEREST DUE as of 09124!2012 PENALTY DUE TOTAL DUE 1!2008 Filed Withholding $4.70 $0.00 $4.70 $1.99 $6.69 1/2008 Filed Employer $716.35 $0.00 $716.35 $290.07 $72.11 $1,078.53 TOTAL $1,085.22 'Unemployment compensation contributions bear interest at the rate of one-twelfth Grdnd Total $1,085.22 (1/12) of the annual rate determined by the Secretary of Revenue under Section 806 $21.50 of the Fiscal Code, 72 P.S. § 806, or at the rate of three quarters of one per centum Filing Fee(5) (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, inGuding after acquired property, of the above named defendant and attach thereto from the date of entry of this Certified Copy of Lien. ~~~ /~~ 'III ~Y: ~~0', A''I II I SALLY L. PIATAK Assistant Director, Office of Unemployment Compensation Tax Service UC-72820121101093030930701019397 Department of Labor & Industry I Office of UC Tax Services ~ 651 Boas Street ~ Harrisburg, PA 17121-0750 i www.dli.state.pa.us dal. 5o P~ PLC Auxiliary aids and services are available upon request to individuals with disabilities. (~"~"Lflra,(p°~ UC-728 REV 09-10 (page 2) Equal Opportunity Employer/Program ~~a x,3007