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  • 1316-MC11864 document preview
  • 1316-MC11864 document preview
						
                                

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1316-MC11864 Missouri DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS Division of Emptoyment Security PO Box 3100, Jefferson City, MO 65102-3100 Ajyeoiuosy99]3, uosyoef pa} THE CLERK OF THE CIRCUIT COURT OF THE COUNTY OF JACKSON, MISSOURI Division of Employment Security State of Missouri vs. RYAN PRUITT SSH XXX-XX-8119 CERTIFICATE OF ASSESSMENT OF OVERPAID BENEFITS The Division of Employment Security, State of Missouri, hereby certifies that, on the 2nd day of August 2013, pursant to the provisions of the Missouri Employment Security Law,Chapter 288, RSMo, an “Order of Assessment of Overpaid Benefits” was made against RYAN PRUITT SS# XXX-XX-8119, an individual , who resides in, or has a place of business in, or has property in the County of Jackson, State of Missouri. It is further certified that the said individual was notified by serving a copy of the said order on above, as required by law. 00:00+LIWD WY 05:80 €T0Z ‘60 Jequiaidas — AID sesuey It is further certified that pursuant to Sections 288.380(11) and 288.160, RSMo, that the Order of Assessment made against RYAN PRUITT has now become final. It is further certified to you, as clerk of said circuit court, that the amount of the said debt assessed for the period 06/30/12 - 12/22/12 and now due and owing the State of Missouri, and more particularly the Division of Employment Security is $1923.00 together with all costs and penalties. IN WITNESS WHEREOF the Division of Employment Security, State of Missouri, has executed these presents at the office of said Division of the City of Jefferson, State of Missouri, this 9th day of SEPTEMBER, 2013. ASSESSMENT No. 000226740 DIVISION OF EMPLOYMENT SECURITY STATE OF MISSOURI CORY GJESVOLD,DEPUTY Benefit Payment Control MODES-4417 (07-08) BPC.