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~A DE~ART"ENT Df REVENUE IUREAU Df CO"~LIANCE DE~T. 21094. HARRISIURa, ~A 17121-094. *' t\l, C{'l-X)55 CU.,....V 7t!r ('I Fll.ED-OFFlCE OF i1-'~ i~r,r 'CNOTP-RY .I~'I" (. JH Ulhl q, SEP 18 Mi 9: 26 ~OURT OP COMMON PLIAS OF CUMt:::.hj<:',J 1:,0L';'~TY PEN~{)"Il.V/,h~^ ,11 q ,lX.) fX'1 (lltl ~q IOq R J:l "\>')'11 CUMBERLAND COUNTY, PINNSYLVANIA SEP 03 1997 NAME ANO ADDRESS, RUSSELL E HOFFMAN 29 S 29TH ST CAMP HILL PA 17011 TO THE ~OTHONOT"'.V Of 1.110 COUlfl ~lIIl11ll,t"'I"""tI..C...._..ll~.t"ftft..h.n'" tllll'.III1"'.Ulltftllul"...hl'lltl,'h"" ILl... u"..,I.,I"""",,ln,_C...,.I,. CIRTIPIID COPY OP LIIN 181-38-5042 . DATI 01" CLAII 0' TAli PUIOD 'UII$MfNT IDrNTl"vINO '" tOTAL ", COlt DUll: DATil DUU,..!NATION NUMllI Oil: IIHLIMlNT , . I . . . P. I. T. 01-01-93 TO AUG 24 1994 M32143 145.68 196 .07 12-31-93 P. I. T. 01-01-95 TO OCT 04 1996 M59'958 53.00 62.52 12-31-95 TOULI tl98.68 1"1'111111 COfIlPUTAl'IQtIl OAn SEP 22 1997 .258.59 'ILINOII'lles, OQ nn TI" ","""1'11'., III' 1..~.Ur., I' 11"""11' C~, 1111 .utll'I'I". '11...", ., tll' e.....II_..lIl1 ...DDIlION,,1. INTlI,,'I' II ,,""",h'"l', "I'tl'l.. till. II II . try. 11'1' ."rut 'UlI' " . 11.,.. ,,1111" tll. ...u. ...n~I"'INT TOTAL. L- 1l...lII t.........r ',r 1111...1, t... '"t.rllt. 11I.ltI0", .r ",".Itlll tlllr",.. d~I 'r... .~III I... "IVlr Ill' .111111. IH." '111I1"_ hr "1'11"'111' tlll"I", rllllll,... ""...1.. 1'11. IIII~"t 0' .....11 1111" IUllII UI. ,"urIU, ...ItIOIl. or ,,".itlll II I 111" I" 'uor 0_ till 'Ol!llll"lfll~tll 0' """''111'''"11 11,,11 till tU"IVlr'. '''Ulrtv. rill, """"11, or 'Itll, II till UIIIIIIII... 'I. _~a.. ~~ (,,,fA,,'" 0' RI\IINlJl IOl AlJ1'MOltllll1 OIl:~(O"'TII PART SEP I 2 1997 0"'" 1 . 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