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BUREAU OF COMPLIANCE DEPARTMENT OF REVENUE
PO BOX 280946
REVK-159(12-12)REVOOOK9 DOCEXEC
HARRISBURG PA 17128-0948
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I'; :' " a ilk CERTIFIED COPY OF LIEN
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P" } COURT OF COMMON PLEAS OF
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BRIDGE ST COFFEE HOUSE T CL VA,NIA EIN:................................................25-1855792/000
1903 BRIDGE ST Notice Date:....................................March 22,2014
NEW CUMBERLND PA 17070- 1128 Notice Number:...............................679-896-114-031-7
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 PERIOD PERIOD TAX TOTAL
BEGIN END
EMPL 90497108 07-01-13 09-30-13 303.92 431.15
TOTAL: 303.92 431.15
FILING FEE(S): 21.50
SATISFACTION FEE(S): 10.00
SETTLEMENT TOTAL: 462.65
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
S C ARY OF REVENUE DATE
(OR UTHORIZED DELEGATE)
PART 1 TO BE RETAINED BY RECORDING OFFICE ,Jul ��'�O
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20 36b S69