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DOCKET NUMBER
Date Entered
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND
COllNTY. PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR'" INDUSTRY
to the use of Ihe
UNEMPLOYMENT COMPENSATION FUND'
tJ.5. ?a,"/ &u:.I~
Dockel Number 222 CIV 1991
Orlllnal Amounl Due: $5,291.24
Plus addlllonal Interesl.
fees and costs.
VI.
THOMAS R , CATHY A MUSGRAVE
20 KOONGALE DRIVE
CARLISLE PA 17013
SUOOI!STION OF NONPAYMENT AND AVERMENT OF DEFAULT
AND NOW. NOVEMBER 07, 1995. the Commonwealth of Pennsylvania.
Department of Labor and Induslry 10 Ihe use of Ihe Unemploymenl Compensalion Fund.
Plainllff-ctalmanl herein. sUQCS15 of record Ihal Ihe above claim Is sllII due and owinl to
the C1aimanl. and avers thai the above-named Defendanl is sllII in defaull for nonpayment
thereof. The prothonotary Is dlreclcd to enler Ihis suacsllon and avermenl on the proper
dockel of said claim. and also 10 Index II In Ihe judlemenl Index for Ihe purpose of
conllnuinl the lien of said claim.
.
161b Floor
L " I Building
Harrisburg. PA 17121
/k ~ 8r;,"'~
SEAN F. CREEO .
Depuly Chief Counsel for Employmenl Securily
ACCOUNT NO.1 21-15106
AD NO.. 227357
DATE. 11/07/95