HomeMy WebLinkAbout04-5517UC-728 REV. 4-04
IN THE COURT OF COMMON PLEAS OF
CUMB~.RLAND 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 e~ered of record by you and
indexed as judgments are indexed.
PENNSYLVANIA EMPLOYER
ACCOUNT NUMBER: 21- 2 0 11 3 8
DOCKET #
DATE ENTERED
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
VS.
KEVIN J SHRAWDER
INDIVIDUALLY & T/A
AUTO EFFEX
1322 SPRING ROAD
CARLISLE PA 17013
AD Number: 308850
QTR/YR. CONTRIBUTION
DUE PAID/CREDIT
BALANCE
INTEREST DUE ON UNPAID
CONTRIBUTION AND / OR
CONTRIBUTION PAID LATE.
3-01 WE .00 .00
3-01 1,519.65 600.00
4-01 WE .00 .00
4-01 862.06 200.00
1-02 WE .00 .00
1-02 1,836.71 200.00
2-02 WE .00 .00
2-02 2,224.45 200.00
3-02 WE .00 .00
3-02 1,527.35 400.00
4-02 WE .00 .00
4-02 1,097.42 200.00
PENALTY DUE -
LATE REPORT/
DISHONORED CHE.
.00 .0
919.65 219.77 151.9
.00 .0
662.06 113.25 86.2
.00 .0
1,636.71 220.51 183.6
· 00 .0
2,024.45 235.62 222.4
· 00 .0
1,127.35 133.21 152.7
.00 .0
897.42 82.21 109.7
sub-total
Additional interest is to be computed on the above balance of unpaid unemployment
compensation contributions at the rate determined by the Secretary of Revenue
under Section 806 of the Fiscal Code, 72 P.S. § 806, per month, or fraction of a
month, from Z 0 / 3 1 / 2 0 0 4
7,267.64 1,004.57 906.7
Filing Fee(s) 14. o o
Additional Interest
The undersigned, Assistant Director, Office of Unemployment Compensation Tax Services, Department of Labor and Industry, certifies that the above unemployment compensation
contributions, interest and penatties are due and p&yabie 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. § 755.1, the above contributions, ~ntarast and penalties ara a lien ~pon the franchises and property, both rest and pareona{, inc{uding after acquired property, of
the above named defendant and affach thereto from the date of entry of this Certified Copy of Lien.
SALLY I. FUHRER
Assistant Director, Office of Unemployment Compensation Tax Sen/ices
TO BE RETAINED BY
RECORDING OFFICE
10/15/2004
DATE
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