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IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
DOCKET # 0(". .:l 511 G..;:,.:.e T-,--
DATE ENTERED:
C~RTIE~ COPY OF LIEN
PoL f/. .. I'I.(JV
~ 1</1290
17756:':1
TO THE PROTHONOTARY OF SAID COURT:
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
vs.
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 judiments are
indexed.
TANA M. CASSELL
22 NORTH HIGH STREET
NEWVILLE, PA. 17241
Social Security Account Number: XXX-XX-3581
Job Center # 0996
CI.lm Week
Endt", Dote
06/09/01
06/16/01
06/23/01
06/30/01
07/07/01
07/14/01
07/21/01
07/28/01
08/04/01
08/11/01
08/18/01
08/25/01
09/01/01
ClYotpotd
Amount
C"lm Week
Endlna o.te
Overpold
Amount
CI.lm Week
Endln. o.te
Overpotd
Amount
Claim Week
Endflll 0..
Overpold
Amo...,
.....,
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<=
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>-
-<
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en (:)
'"t7 :t!...,
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N ~
-<
Minus Amount Repaid
[-_jr.l~~l~}:filiili~~Iilii:~:f:~:iliffif:Ur.fili*t~:tili~tli)._:
$302.00
Additonal interest will accrue on the balance due of
the above overpaid unemployment compensation
benefits after 03/31/06. For the total amount due
on this lien, phone (717) 783-3140.
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The undentlMd, AsslsWlt Olr_r, Bureau of Unemployment Compensation Beneflb and Allowances, Oepartment of Labor and Industry of the
Commonwealth of Pennsylvania, certifies that the above penon Is obllpted, punu.nt to 43 P .5. . 874(.) to repay the above over'JHlld
unemployment compenAtlon benefits received by hlmlher toaether with Interest thereon, charpd per month or frKtlon of .. month,
beIInnl.. fifteen (15) days after the Notice of OWrpayment was IHUed and contlnuln. until tha overpaid beneflb 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.S. II 874(a) and 788.1, the
above ovwpald unemployment compensation benefits .nd tnterest .re . lien upon the fr.nchtses .nd property, both rul .nd penon.l,
Includtnl after...cqulred proparty, of the above panon and attach thereto from the date of entry of this CortIfled Copy of Lien.
_O~J?:J?.il-g,,-._,,_........
c'? .
Chief of UI Claims Services
April 21, 2006
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