HomeMy WebLinkAbout99-00465
PA DEPARTHENT OF REVENUE
BUREAU OF CDHPLIANCE
DEPT. 280946
HARRISBURO, PA 17128-0946
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COURT OF COMMON PLEAS OF
,It 9,\.>0 fd C:.\.Uo\ '2nQ 2:>5
CUMBERLAND COUNTY,
23-2205179
R,1l. 'll.D05'7
PENNSYLVANIA
NAME AND ADDRESS:
MARK A ITTER
TND AND AS PRES OF
AMBULANCE TRANSPORT INC
362 N 24TH ST
CAMP HILL PA 17011
TO THE PROTHONOTARY OF SAID COURTl CERTIFIED COpy OF LIEN
'urtulWlt to tl'll lau 01 th.Collunulltho".MS}lvlft1"
tl'l.,.. hl'llru1th tr.l\uttt.d.. CtfUt1ldCo,WI' I L1tn
tob,.ntlr." O'rtUrd lnrour Coyntr.
DATE OF
CL.tro:::S OF TAl( PERIOD ASSESSMENT IDENTIFYINQ
DETERMINATION lA, TOTAL
lA, {OR DUE DATEI NUMBER
OR SETTLEMENT
. , .
EMPL 01-01-95 TO 08-26-98 Q55341 C01 $219.53 $354.12
03-31-95
01-01-97 TO 08-26-98 Q77 41 7 C01 1,902.66 3,352.28
03-31-97
04-01-97 TO 08-26-98 Q77418 C01 2,019.68 3,232.05
06-30-97
07-01-97 TO 09-02-98 T77639 C01 1,828:52 3,158.87
09-30-97
10-01-97 TO 09-02-98 T77640 C01 2,306.70 3,587.12
12-31-97
INTEREST COMPUTATION DATE
02-15-99
TOTALS
$8,277.09
$13,684.44
FiliNG FEEISI
9.00
TII. uncl.rsJln.cl, tll. S.cr.t.rl/ 0' R'II.nu. (or IIts .utllorJud d,lIgtt.l 0' tll. COl,ullonwu1tn
0' P.nnSl/1II.n!., c.rt.\;Ju tllJc to D. . true and corr.ct COIll/ 0' I J1In ,uJnst tll. .Do....-
n"!lId t,o'l/.r '01'" unll.Jd till:, Jnt.rut, .ddltlons or lI.n.UJts tn,rlon clu. 'rom sucll tu-
pIl/lr .nd""IIJcl'I, If tel'" Cl'lII.nd 'or 1I''Im'nt tllll""o', r...Jnsunp.Jd. TII. ,mount 0' sucllun-
lI.ld till, Jnt.rut, .dd.lt1onl or p.n.1tlu Is. 11an In "1101'" 0' tll. Com,"onwllltll 0' Pannly1ll.nJa
upon tn. tlllp'l/ar's propartl/, 1"'..1, p.rsonal. or Dotn, II tll. cu. mll/ D..
ADDITIO~Al INTEREST
SETTlEMENT TOTAL
~a..~
SECRETARY OF REVENUE
. . 1.0 AUTH.""" DELE.A", PART
/_ d /. '/7
DATE
1 - TO BE RETAINED BY RECORDING OFFICE