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06-3493
~. f1l ~ fl/. tfD '* REV.1S9 eM AFP (6196) BUREAU OF COMPLIANCE P.O. Box 280948 HARRISBURG, PA 17128-0946 Ck.. J 31(~1 R<<-. ) I '131(, <) f '" = c:::.::. ~::r. o -17 ::;:! n~E t', j ,< ~~: ::..-: ~.J/, "", c:, 2_~ i,~~~ t,:~ :0.-:1 ~,;; ::.< co COURT OF COMMON PLEAS OF /L.Ot,.. 3Yc;.3 Ct.uuT~ CUMBERLAND COUNTY, PENNSYLVANIA 23-2296489 o NAME AND ADDRESS: ROBERT E JACKSON JR 1112 SLATE HILL RD CAMP HILL PA 17011 TO THE PROTHONOTARY OF SAID COURT: PURSUAN'rTO THE LAWS OfI'THE COMMONWI:AL 1H OF PENNSYLVANIA =i=~~~"":YonlEN CERTIFIED COpy OF LIEN DATE OF CLASS OF TAX PERIOD ASSESSMENT IDENTIFYING TAX TOTAL TAX (OR DUE DATE) DETERMINATION NUMBER OR SETILEMENT PTA 10/1/96-9/30/04 A50530 $2,615.00 $5,589.13 TOTALS $2,615.00 $5,589.13 FILING FEE (S) INTEREST COMPUTATION DATIr 1l112!l1~ 14.00 The undmigned. the Secretary ofrtvellue (or his IUthorized delegate) oflbe Commonwealth ADDITIONAL INTEREST ofPcnnsylvania,cenifielthialobetrueandoorrccttopyofalienagainsttheabovenillTled tupayer for unpaid tax, interest. addition! or penalties thereon due from such taxpayer and which, U\er demand for payment thereof, remains unpaid. The amount of wch unpaid IoU, lnten'll, additions or pentltiCl il a lien in favor oCthe commOllwealth ofPCDnsylvania upon SETTLEMENT TOTAL the taxpayer's property, ,personal,orboth,uthecasemlybe /) ENUE ELEGATE) PART 1 - TO BE RETAINED BY RECORDING OFFICE JUN 12 Z006 DATE 0' ~ ~ ;:~ .. :I ~ : ~ .... . . ~N" ... ~ ::: :..'" ::'-i: . . . .. . :!.;: =- .:::''' o. . . , :-~a. . . . . . . . - . . . . . . . . . . ~ !'- o (., ~ ! . . . . . . . -. . . . _N_ - . . . , . - . : : . . , . ~. , . : . . . . . . . . . . " . C . . . , . X . . . . . . , . . . ~. . . . . . . . . : - . . " : . . ~ , " , ; , . . ~ . . . . . . ~ !" ~ -.of ;: . . , . . . N. . . . . :v 5 1 ~ .. . . . , . . . ., . .. :~:: .. . J :;':;t: "" ;I !: .. IIlN":1 ......'011. N N 0 , . . . . . . . .. ... . . . . . . .. x . . .. . ~ =- . ..c . . ~ ~ .. . . , ... :! 5 :: . a. ~ .. . o ~ . 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