HomeMy WebLinkAbout06-5852
UC-728 REV. 1-06
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DATE EN'tE'RE[):p,.
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IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
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CERTIFIED COpy OF LIEN
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
TO THE USE OF THE
UNEMPLOYMENT COMPENSATION FUND
TO THE PROTHONOTARY OF SAID COURT:
Pursuant to Section 308.1 of the
Pennsylvania Unemployment
Compensation Law, 43 P.S. i 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.
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SUMMIT STAFFING SOLUTIONS INC
3920 MARKET ST
CAMP HILL PA 17011
.
ACCOUNT NUMBER:
AD Number:
320645
OTRlYR. CONTRIBUTION
DUE PAID/CREDIT
1-03 WE 5.08 5.08
1-03 1,469.63 1,469.63
3-03 WE 2.32 2.32
3-03 335.02 2.32
3-03 CP
INTEREST DUE DN UNPAID
CONTRIBUTION AND I OR
CONTRIBUTION PAID LATE,
BALANCE
.00
.00
.00
337.34
6.14
52.00
"WE" refers to withholding for employee contributions,
sub-total
AcIditional interest is to be computed on the above balance of unpaid unemployment
compensation contributions at the rate of one-twelfth (1/12) of the annual rate
determined by the Secretary of Revenue under Section 806 of the Fiscal Code, 72
P.S. ~ 806, per month or fraction of a month, or at the rate of three quarters of one
per centum (0.75%) per month or fraction of a month, whichever is greater, from the
date they become due until paid, from 09/30/2006.
.....A4~I~W~~[lt.~F...........,........)................
Additional Interest
PENAL TV DUE
(see reverse for
explanation)
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. 6 788,1, the above contributions, Interest and penalties are a lien upon the franchises and property, both real and personal, including after acquired property, of
the above named defendant and attach thereto from the date of entry of this Certified Copy of Lien,
CYPbr~~~
SALLY L. PIATAK
Assistant Director, Office of Unemployment Compensation Tax Services
TO BE RETAINED BY RECORDING OFFICE
09/13/2006
DATE
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