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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
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BUREAU OF COMPUANCE
DEPT. 280948
HARR.18BURG, PA 17126-094E
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CERTIFIED COpy OF LIEN
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COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,
PENNSYLVANIA
GEMBUSIA, JOSEPH T
3510 RAINTREE LN
MECHANICSBURG PA 17050-2259
SSN: 173-36-8376/000
Notice Date: February 6, 2005
Notice Number: 169-208-405-020-1
To the Prothonotary of said court: Pursuant to the laws of the
Commonwealth of Pennsylvania, there is herewith transmitted a certified
copy of a lien to be entered of record in your county.
1 2 3 4 5 6 7
TAX TYPE ACCOUNT 10 TAX TAX EVENT TAX TOTAL
PERIOD PERIOD NUMBER DUE DUE
BEGIN END
USE 10170939 01-01-04 01-31-04 1 249.00 304.05
TOTAL: 249.00 304.05
FlUNG FEElS): 14.00
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INTEREST COMPUTATION DATE: 02-16-05
The undersigned, the Secretary of Revenue (or an authorized delegate) of the Commonwealth of Pennsylvania, certifies this to be a true and correct
copy of a lien against the ebove named taxpayer tor unpaid TAX, INTEREST, ADDiTIONS or PENALTIES therein due from such taxpayer and which,
after demand for payment thereof, remains unpaid. The amount of such unpaid TAX, INTEREST, ADDITIONS or PENAL TIES is a lien in favor of the
Commonwealth of Pennsylvania upon the taxpayer's property, real, personal, or both, as the case may be.
February 6, 2005
DATE
PART 1 - TO BE RETAINED BY RECORDING OFFICE