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BUREAU OF COMPLIANCE DEPARTMENT OF REVENUE
PO BOX 280948 REVK-1 59(12-12)REV0001<9 DOCEXEC
HARRISBURG PA 17128-0948
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CERTIFIED COPY OF LIEN _V)t-R0Tfjt' 11LIO,
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JL'I- COURT OF COMMON PLEAS OF
C'JPTERLIqND COU CUMBERLAND COUNTY,
PEN�ISVI�IbANI 11TY PENNSYLVANIA
NEW KINGSTOWN MARKE EIN:................................................25-1793305/000
21 W MAIN ST Notice Date:....................................May 20,2014
NEW KINGSTOWN PA 17072 Notice Number:...............................792-865-814-051-5
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 80349319 11-01-13 11-30-13 108.97 290.90
TOTAL: 108.97 290.90
FILING FEE(S): 21.50
SATISFACTION FEE(S): 10.00
SETTLEMENT TOTAL: 322.40
INTEREST CALCULATION DATE: 08-13-14
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 taxpayers property-real,personal or both-as the case may be.
May 20,2014
S S -C ARY OF
C Y
OF REVENUE DATE
T 0 IZ
KUT
(OR HORIZED DELEGATE)
PART 1 -TO BE RETAINED BY RECORDING OFFICE CL wj &a_I,50 P