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UC,728 REV. 4,04
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
fJd..- P1/ ' l'f,{)t>
CR. /ORQq ~ 1''12'11
CERTIFIED COpy OF LIEN
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.
PENNSYLVANIA EMPLOYER
ACCOUNT NUMBER: 21-19709 2
AD Number:
313490
QTRlYR. CONTRIBUTION
DUE PAID/CREDIT
1-02 WE .00 .00
1-02 413.90 413.90
3-02 WE .00 .00
3-02 255.77 151.71
4-02 WE .00 .00
4-02 211.13 211.13
1-03 WE 5.37 5.37
1-03 1,446.06 1,446.06
2-03 WE 6.39 .00
2-03 976.82 500.00
3-03 WE 7. 51 7.51
3-03 369.12 369,12
sub-total
()
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COMMI)NWEAL TH OF PENNSYLVA):lIA -<
DEPARTIIIIENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
.
vs,
BRYAN L BRADLEY (INDIVIDUALLY &
TRADING AS) B L BRADLEY BUILDING &
REMODELING
1864 WALNUT BOTTOM RD
NEWVILLE PA 17241
.
INTEREST DUE. ON UNPAID ?ENALT'I DUE -
CONTRIBUTION AND I OR LATE REPORT!
BALANCE CONTRIBUTION PAID LATE. DISHONORED CHECK
.00 .00
.00 2.16 4,14
.00 .00
104.06 25,94 .00
.00 .00
.00 33,62 .00
.00 .00
.00 25.81 5.37
6.39 .00
476.82 84,17 .00
,00 .00
.00 1. 57 37.66
50,09
47.17
dditional interest is to be computed on the above balance of unpaid unemploymen1.
tH'npensation contributions at the rate determined by the Secretary of Revenue
r1der Section 806 of the Fiscal Code, 72 P.S, 0 806, per month, or fraction of a
lonth, from 09/30/2005
The undersigned, Assistant Director, Office of Unemployment Compen,atlon Tax Services, D.partment of Labor and Indlls1ry, certifies that the above unemployment compensation
contributions, Interest and penaflles are due and payable by th. &bov. named defendant under the provisions of the Perlnsylvanla Unemployment Compensation Law. Pursuant to Section
308.1 of said Law, 43 P.S. f 788.1, the above contrIbutIons, lntelu\ and penaltIes aTe a nen upon the francl1lses and prop.rty, both real and personal, InclUding after acquired property, of
""6;;;---..~-'._.""-"'."-
SALLY L. FUHRER
Anlslant Dlr.ctor, Office of Unemployment Compensation Tax Services
TO BE RETAINED BY RECORDING OFFICE
09/14/2005
DATE