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NDOL Serial No.: 1 LAB -0248 -2013 <br />To be filed with the Register of Deeds in the following Counties: <br />NDOL Acct. No.: 1 0321290003 <br />Hall . <br />Interest <br />Through <br />7/23/2013 <br />Subtotal <br />Federal ID No. / SSA No.:1341982626 <br />7/8/2013 <br />$23.03 <br />$0.00 <br />Qtr. / Yr. <br />Date Assessed <br />Combined Tax Or Payment In Lieu <br />Of Contributions Due <br />Penalty <br />Interest <br />Through <br />7/23/2013 <br />Subtotal <br />2/2009 <br />7/8/2013 <br />$23.03 <br />$0.00 <br />$1650 <br />$ 3953 <br />3/2009 <br />7/8/2013 <br />$0.00 <br />$40.61 <br />$0.00 <br />$ 40.61 <br />1/2010 <br />7/8/2013 <br />$651.51 <br />$0.00 <br />$381.67 <br />$1,033.18 <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />TOTAL Combined Tax or payment in Lien of Contributions Due (under this lien only); <br />$1,113.32 <br />0 <br />Jul. 31. 2013 3:17PM NE Secretary of State — UCC <br />STATE TAX LIEN ❑ NEBRASKA DEPARTMENT OF LABOR <br />• ORIGINAL <br />Date: July 31, 2013 <br />Employer or <br />Liable Person: Midwest Mfg. Co. Inc. <br />Address: 1515 East Fourth St. Grand Island NE 68802 <br />T :IDOCUMENTSWORMS\L.iens Original lien.docx <br />201306184 <br />RETURN FILED COPIES TO: Nebr. Dept. of Labor - LEGAL <br />PD. Box 94600 <br />Lincoln, NE 60509.4600 <br />Co <br />f La <br />No. 0182 P. 2/3 <br />1 L. .t S1.lo John A Gele - UCC iTl <br />9913720008 -1 Pea: 1 <br />MIDWEST MPG. CO. INC. <br />Flled: 07/31/2013 11:13 AR <br />NDOL Office of Legal Counsel <br />P.O. Box 94600 <br />Lincoln, NE 68509 -4600 <br />Telephone - (402) 471 -9912 <br />FAX - (402) 471 -9917 <br />This State Tarr Lien is issued for unpaid combined taxes (Neb. Rev. Slat §§48.657 and 48 .664) or payments in lieu of contributions (Neb. Bev Stat. §4 8-660.01) pursuant <br />to the Uniform State Tax Lien Registration & Enforcement Act (Neb. Rev. Stab §77 -3901, er seq.). Notice is given that combined taxes or payments in lieu of <br />contributions, interest (computed at 1.5% per month), and penalties are due from this employer or person and remain unpaid after demand. These combined taxes or <br />payments in lieu of contributions constitute a lien for any and all personal property and real property in the county /counties named, belonging to the employer or person, <br />whether now owned Or hereafter acquired, <br />I certify that the Nebraska Department of Labor has complied with the Employment Security Law of the State of Nebraska in the <br />determination of the amount due, and the employer or person has failed to pay the amount due after demand. <br />CATHERINE D. LANG <br />, Agency Legal Counsel <br />MAS A. ' INSK!, Legal Counsel <br />TIE S. BALTENSPERGER, Legal Counsel <br />NEBR. DEPT. OF LABOR <br />CHARGE ACCT. #14765 <br />