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DEPARTMENT OF REVENUE
BUREAU OF COMPLIANCE I
PO BOX 280948 REVK-159(12-12)REV0001<9 DOCEXEC
HARRISBURG PA 17128-0948
CERTIFIED COPY OF LIEN
)O A
2014 NIA Y 2 8 Pill 2: 0 3 COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,
CIUMBERLAND COUNTY PENNSYLVANIA
L EIN:................................................25-1847759/000
QUIRK , KEVIN G PENNSYLVANIA Notice Date:....................................March 22,2014
3677 SPRING RD Notice Number:...............................680-031-314-031-7
CARLISLE PA 17013-8737
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 50042692 07-01-11 09-30-11 0.00 12.06
SALES 50042692 10-01-11 12-31-11 0.00 19.07
EMPIL 91925978 01-01-13 03-31-13 86.65 132.90
EMPL 91925978 07-01-13 09-30-13 153.90 218.32
TOTAL: 240.55 382.35
FILING FEE(S): 21.50
SATISFACTION FEE(S): 10.00
SETTLEMENT TOTAL: 413.85
INTEREST CALCULATION DATE: 06-15-14
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.
March 22,2014
R,eARY OF REVENUE DATE
(OR AUTHORIZED DELEGATE) PART 1 -TO BE RETAINED BY RECORDING OFFICE
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