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UC-728 REV. 4-04
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
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DOCKET #
DATE ENTERED
CERTIFIED COPY OF LIEN
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
TO THE PROTHONOTARY OF SAID COURT:
Pursuant to Section 308.1 of the
Pennsylvania Unemployment
Compensation Law, 43 P.S. 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.
.
vs.
PROFESSIONAL DECK SEALING INC
4193 NANTUCKET DRIVE
MECHANICSBURG PA 1'{d55
.
PENNSYLVANIA EMPLOYER
ACCOUNT NUMBER: 21-19525 1
\i
AD Number:
310081
OTRlYR.
OUE
CONTRIBUTION
PAID/CREDIT
BALANCE
INTERE~OUE 0 PAm
CONTRI8\"tT\ON AIIW lJ OR
CON1RI~i:ION PAl{)..LJ\TE:.
PENALTY DUE -
LATE REPORTI
DISHONORED CHECI
2-04 WE
2-04
22.75
3,362.32
22.75
2,041.70
.00
1,320.62
.OC
.01
,.. 33~1
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sub-total
1 320.62
33.01
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 02/28/2005
Interest
ThfllJnc:lllfslgned, Assill'lant DIrector, Office of Unemployment Compensation Ta)l SeNlces, Department of labor and Industry, carlif)e, that the above unemployment compensa.llon
contributIons, Interest and penalt!.., are due and payable by the above named defendant under the provisions of the Pennsylvania Unemployment CompensatIon Law. Pursuanl to Sectle
308.1 of sald Law, 43 P.S. , 188.1, the above contributIons, Interest and penaltIes are a lien upon tMe franchlaes and property, both real and perSOf'lal, lrrelud)flg after acquIred property,
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~., I V L. FUHRER
02/17/20
DATE
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