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IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
DOCKET # u & . j J I f' Cl..',~i -r;:,,~
DATE ENTERED:
Cj;:RTIFIED COPY OF LIEN
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TO THE PROTHONOTARY OF SAID COURT:
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
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.
\IS.
SUNDANCE STOTTLEMYER
173 TIMOTHY DRIVE
CROSSVILLE, TN 38572
Social Security Account Number: XXX-XX-1027
Job Center # 0996
Claim Week Overpaid Claim Week Overpaid Claim Week Overpaid
Ending Oilte Amount Endins O.te Amount Endin, Date Amount
03/31/01 $22.00 07/07/01 $126.00
04/07101 $126.00 07/14/01 $126.00
04/14/01 $126.00 07/21/01 $126.00
04/21/01 $126.00 07128/01 $126.00
04/28/01 $126.00 08/04/01 $126.00
05/05/01 $126.00 08/11/01 $126.00
05/12/01 $126.00 08/18/01 $126.00
05/19/01 $126.00 08/25/01 $126.00
OS/26/01 $126.00 09/01/01 $63.00
06/02/01 $126.00
06/09/01 $126.00
06/16/01 $126.00
06/23/01 $126.00
06/30/01 $126.00
CI.lm Week
Endtn. Date
Overpaid
Amount
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Additonal interest will accrue on the balance due of
the above overpaid unemployment compensation
benefits after 01/31/06. For the total amount due
on this lien, phone (717) 783-3140.
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........................ --- ---.......
Minus Amount Repaid
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......................
Plus Interest
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$0.00
,.,...,.,...I..I:.~!!~111~!
$627.80
The understaned, Asststant Director, Bureau of Unemployment Compensatton Beneflts and Allowances, Department of Labor and Industry of the
Commonwealth of Pennsylvania, certtfles that the above person Is obltpted, pursuant to 43 P .5. I 814(8) to repay the above overpaid
unemployment compensation beneflts received by hlmlher toaett1er with Interest thereon, charaed per month or fraction of a month,
beatnntnl fifteen (15) days after the Notice of Overpayment was Issued and conttnulna until the overpaid beneflts are repaid. The Interest rate
Is determtned by the Secretary of Revenue as provided by Section 806 of the Fiscal Code. In accordance with 43 P .5. II 874(a) and 788.1, the
above overpatd unemployment compensation beneflts and interest are a lien upon the franchises and property, both real and personal,
includtnlafter~acquired property, of the above person and attach thereto from the date of entry of this Certified Copy of Lien.
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Chief of UI Claims Services
February 17, 2006
Date
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