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IN THE C0URT OF C 6�46 k- DOCKET NUMBER: )Li 0
CUMBERLAND COUNTY,O-E-NNSYLVAMX, 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: VS.
Pursuant to Section 308.1 of the 0
Pennsylvania Unemployment CINDY DURBOROW
Compensation Law,43 P.S. §788.1, "Trading as"
this is a Certified Copy of Lien for CINDYS SNACK BAR
unpaid unemployment compensation 1800 ELMERTON AVE
contributions, interest and penalties to 0 HARRISBURG, PA 17110
be entered of record by you and
indexed as judgments are indexed.
AD Number: 631951
OTHER PENALTIES
DATE AMOUNT PAYMENTS/ BALANCE
ASSESSED TYPE ASSESSED CREDITS DUE
08/19/2013 CIVIL $1,500.00 $0.00 $1,500.00
TOTAL $1,500.00
*Unemployment compensation contributions bear interest at the rate of one-twelfth Grand Total $1,500.00
(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.
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SALLY L. PIATAK K, .?CW
Assistant Director,Office of Unemployment Compensation Tax Service UC-72820141204105345369662805743
Department of Labor&Industry I Office of UC Tax Services 1651 Boas Street I Harrisburg, PA 17121-0750 1 www.uc.pa.gov
Auxiliary aids and services are available upon request to individuals with disabilities. vA -%Ok 1TV1 Li"SOP0
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