HomeMy WebLinkAbout08-6434COMMONWEALTH OF PENNSYLVANIA
BUREn OFCOMPLIgNCE NUE DEPARTMENT OF REVENUE
LIEN SECTION
PO BOX 280948
HARRISBURG PA 17128-0948
J - ^~ r,/~` ' n` REV-159 ql DOCE7Q':C (03-06)
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COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
JOSE M ORTIZ
NAME AND ADDRESS: 101 MAY DR
APT 4
CAMP HILL PA 17011
TO THE PROTHONOTARY OF SAID COURTS CERTIFIED COPY OF LIEN
Porauent to tn. Iera of tM Coaeomwelth of P.nn:ylranfs.
trier. 1s herwlth trenmdttetl • artifice rnpy o} • Ii.n 64 0 - 3 0 - 0 0 9 3
to b..nt.ntl o} roeord in your county
CLASS OF TAX PERIOD DATE OF ASSESSMENT
DETERMINATION OR IDENTIFYING
TAX (OR DUE DATE) SETTLEMENT NUNRER TAX TOTAL
1 2 3 4 5 6
P.I.T. 01-01-04 TO APR 04 2008 L48996 611.00 814.85
12-31-04
TOTALS
5611.00 5814.85
INTEREST COMPUTATION DATE JAN 1 5 2 0 0 9 FIL IN6 FEE(S)
519.00
ADDITIONAL INTEREST
Th• undersiOned, the Seeretarv of Revenue Cor his authorized delepats) of th• Coaaonwsslth of
Pennaylvania, certifies this to b• a true and correct copy of alien a0ainst the above-naaed
taxpayer for unpaid tsx, interest, additions or penalties thereon due from such taxpayer
and which. after deaand for payaent thereof, regains unpaid. The mount of such unpaid SETTLEMENT TOTAL
t
i
t
t
dditi 5 g 3 3
85
ax,
n
eres
, a
ons or penalties is a lien in favor of the Coaaonrealth of Pennsylvania .
rOCt 2 8 20~
SECRETARY OF REVENUE DATE
(OR AUTHORIZED DELEGATE) PART 1 - TO BE RETAINED BY RECORDING OFFICE
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