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BUREAU OF COMPLIANCE DEPARTMENT OF REVENUE
PO BOX 280948 REVK-159(12-12)REV000K9 DOCEXEC
HARRISBURG PA 17128-0948
j NO CERTIFIED COPY OF LIEN
2 7 AN 8: COURT OF COMMON PLEAS OF
CUMBERL4 CUMBERLAND COUNTY,
CHON MOTEL ENTERPRISE�E�INE i YI-VNO COUNT' PENNSYLVANIA
ANIA EIN:................................................20-0130565/000
227 EWE RD Notice Date:....................................April 20,2014
MECHANICSBURG PA 17055-4875 Notice Number:...............................749-388-714-041-5
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
TAX TYPE ACCOUNT ID TAX TAX TAX TOTAL
PERIOD PERIOD
BEGIN END
SALES 82777535 11-01-12 11-30-12 5,593.72 8,260.97
SALES 82777535 01-01-13 01-31-13 4,986.00 7,338.09
SALES 82777535 03-01-13 03-31-13 4,718.59 6,920.98
SALES 82777535 10-01-13 10-31-13 6,112.40 7,330.92
TOTAL: 21,410.71 29,850.96
FILING FEE(S): 21.50
SATISFACTION FEE(S): 10.00
SETTLEMENT TOTAL: 29,882.46
INTEREST CALCULATION DATE: 07-14-14
The undersigned,the Secretary of Revenue or authorized delegate of the Commonwealth of Pennsylvania, certifies this to be a true and correct copy
of a lien against the above-named taxpayer for 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 penalties is a lien in favor of the Commonwealth of
Pennsylvania upon the taxpayer's property-real,personal or both-as the case may be.
April 20,2014
S CPfeARY OF REVENUE DATE
(OR AUTHORIZED DELEGATE)
PART 1 -TO BE RETAINED BY RECORDING OFFICE S6 1.)
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