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UC-728 REV. 4-04
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
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CERTIFIED COpy OF LIEN
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DATE ENTERED
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
f' :
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.
vs.
.
TIMOTHY J WILBUR
INDIVIDUALLY & T/A
TIM WILBUR MECHANICAL CONTRACTING
507 N YORK STREET
MECHANICSBURG FA 17055
.
PENNSYLVANIA EMPLOYER
ACCOUNT NUMBER: 21- 2 0 5 9 7 4
AD Number:
313157
CONTRIBUTION INTEREST DUE ON UNPAID PENAL TV DUE -
QTRlYR. CONTRIBUTION AND I OR LA TE REPORT I
DUE PAID/CREDIT BALANCE CONTRIBUTION PAID LATE. DISHONORED CHECK
2-02 WE .00 .00 .00 .00
2-02 904.59 904.59 .00 35.80 .00
4-04 WE 72.53 72.53 .00 .00
4-04 1,016.83 327.47 689.36 27.97 .00
2-05 WE 54.88 .00 54.88 .00
2-05 1,304.27 .00 1,304.27 11.33 .00
I sub-total 2,048.51 75.10 .00
::iditional interest is to be computed on the above balance of unpaid unemployment
)mpensation contributions at the rate determined by the Secretary of Revenue
lder Section 806 of the Fiscal Code, 72 P.S. ~ 806, per month, or fraction of a
onth, from 09/ 3 0/ 2 0 0 5
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 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
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09/02/2005
DATE
SALLY L. FUHRER
Assistant Director, Office of Unemployment Compensation Tax Services
TO BE RETAINED BY RECORDING OFFICE
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