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BPA DEPARTMENT OF
UREAU OF OMPLANCENUE ;< Pennsylvania
LIEN SECTION DEPARTMENT OF REVENUE
PO BOX 280948
HARRISBURG PA 17128-0948
REV-159 CM DDCEXEC (12-13)
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA C,)`"�
C—)
CO
NAME AND ADDRESS:
MICHAEL K CLOUSER
317 E PORTLAND ST
MECHANICSBURG PA 17055-3355
TO THE PROTHONOTARY OF SAID COURT: CERTIFIED COPY OF LIEN
Pursuant to the laws of the Commonwealth of Pennsylvania,
there is herewith transmitted a certified copy of a lien 207-58-8524
to be entered of record in your county
CLASS OF TAX PERIOD DATE OF ASSESSMENT IDENTIFYING
DETERMINATION OR TAX TOTAL
TAX (OR DUE DATE) SETTLEMENT NUMBER
1 2 3 4 5 6
P . I .T . 2010 DEC 10 2013 003740 1093. 16 1505 . 79
P . I .T . 2011 NOV 13 2013 N15998 1876 .23 2520 .50
TOTALS
$2969 .39 54026. 29
INTEREST COMPUTATION DATE O C T 30 2014 FILING FEE(S)
$21 . 50
The undersigned, the Secretary of Revenue (or his authorized delegate) of the Commonwealth of SATISFACTION FEE(S) 5 10 . 0 0
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 thereon due from such taxpayer ADDITIONAL INTEREST
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.
SETTLEMENT TOTAL *4057. 7 9
PO PLPF
AUG 07 2014 L'#��I0851
SECRETARY OF REVENUE DATE ���3 13 501
(OR AUTHORIZED DELEGATE) PART 1 — TO BE RETAINED BY RECORDING OFFICE