IN THE COURT OF COMMON PLEAS OF ADAMS COUNTY, PENNSYLVANIA CIVIL ACTION – LAW

Name

V.

Plaintiff

Case No._____

Adams County Board of Assessment Appeals,

Defendant

CERTIFICATE OF SERVICE

The undersigned hereby certifies that on this date, a true and correct copy of the Tax Assessment Appeal filed _____ was served by first class mail on the other party as follows:

Adams County Board of Assessment Appeals 117 Baltimore Street, Room 202 Gettysburg, PA 17325

Date:_____

By:_____

Signature of ()Plaintiff ()Defendant