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DATE ENTERED
IN THE COURT Of COMMON PLEAS Of
CUMBERLAND COUNTY, PENNSYLVANIA
CERTifiED COPY Of LIEN
COMMONWEALTH Of PENNSYLVANIA
DEPARTMENT Of LABOR AND INDUSTRY
TO THE USE Of THE
UNEMPLOYMENT COMPENSATION fUND
vs,
TO THE PROTHONOTARY Of SAID COURT:
P,L (J 1/1 1'1,00
ex. /oSJO Ru... !f.tfO<f3
Pursuant to 43 P,S. S S 874(a) and 788.1, this is a
Certified Copy of Lien for overpaid unemployment
compensation benefits and interest to be entered
of record by you and indexed as judgments are
indexed.
COREY E. TAYLOR
62 PEACHY ANN DRIVE
NEWVILLE, PA 17241
Social Security Account Number: _6271
Job Center #: 0996
Claim Week Overpaid
Endins Date Amount
09-11-99 $219,00
09-18-99 $219,00
Overpaid
Amount
Claim Week
Ending Date
Overpaid
Amount
Overpaid
Amount
Claim Week
Ending Date
Claim Week
EndinB Date
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Additional interest will accrue on the balance due of the
above overpaid unemployment compensation benefits
after 08-31-2005 For the total amount due on this
lien, phone (717) 783-3140,
$14.00
Filing Fee
The undersigned, Assistant Director, Bureau of Unemployment Compensation Benefits and Allowances, Department of labor and Industry of the
Commonwealth of Pennsylvania, certifies that the above person is obligated, pursuant to 43 P.S. !i 874(a) to repay the above overpaid unemployment
compensation benefits received by him/her together with interest thereon, charged per month or fraction of a month, beginning fifteen (15) days after the
Notice of Overpayment was issued and continuing until the overpaid benefits are repaid. The interest rate is determined by the Secretary of Revenue as
provided by Section 806 of the Fiscal Code. In accordance with 43 P .5. S S 874(a) and 788.1, the above overpaid unemployment compensation benefits and
interest are a lien upon the franchises and property, both real and personal, including after-acquired property, of the above person and attach thereto from
the date of entry of this Certified Copy of Lien.
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/ , September 15. 2005
, "effief of VI Claims Services Date
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