|
�
<br /> ?8-� U O 110 7
<br /> GERALD E. CHIZEK, ) Certificate of Lien
<br /> Commissioner of Labor, ) or Delinquent
<br /> ) Unemployment Insurance Contributions
<br /> vs. ) (
<br /> ( �
<br /> Harold Rosenkotter, d/b/a )
<br /> B & D DAYLIGHT DONUTS SHOP, )
<br /> Employer Acet. #83319-008-5812)
<br /> TO WHOM IT MAY CONCERN:
<br /> The undersigned James R. Jones, attorney for Gerald E.
<br /> Chizek, the duly appointed, qualified, and acting Commissioner of
<br /> Labor of the State of Nebraska, does hereby certify that Haro].d
<br /> Rosenkotter, doing business as B & D Daylight Donuts Shop, doing
<br /> business in Grand Island, Hall County, Nebraska, is indebted to the
<br /> Unemployment Compensation Fund of the State of Nebraska for contri-
<br /> butions due on his employment for the third and fourth quarters of
<br /> 1977 in the sum of $384.22, and interest in the sum of $16.71, with
<br /> interest at the rate of one per cent per month on the sum of $384.22,
<br /> from February 27, 1978.
<br /> By reason thereof, said Gerald E. Chizek, as Commissioner
<br /> of Labor, on behalf of the Unemployment Compensation Fund, hereby
<br /> claims a lien in the sum of $400.93, with interest at the rate of
<br /> one per cent on the sum of $384.22, from February 27, 1978, until
<br /> paid, upon any and all property, real or personal, of said B & D
<br /> Daylight Donuts Shop, and specifically claims a lien on the following
<br /> described real estate:
<br /> Harold Rosenkotter
<br /> Lot 8, Meadowlanes 4th Subdivision, Grand Island,
<br /> t Hall County, Nebraska
<br /> ' i
<br /> subject only to liens of prior record pursuant to Section 48-657,
<br /> R.R.S., Nebr. , 1943.
<br /> i
<br /> k -'
<br /> � � �`'--:�G�=�22���7 ��� '�-G��'1 �
<br /> MES R. JONES �
<br /> ATTORNEY FOR
<br /> GERALD E. CHIZEK, COMMISSIONER OF LABOR
<br /> February 27, 1978
<br /> STATE OF NEBRASKA )
<br /> ) ss.
<br /> � LANCASTER COUNTY )
<br /> James R. Jones, being first duly sworn upon his oath,
<br /> deposes and says that he is attorney for Gerald E. Chizek, Commissioner
<br /> of Labor of the State of Nebraska; that he is authorized to make the
<br /> - above certificate; that the facts set out above are true and correct.
<br /> �; .��.� �z, ,�
<br /> James R. � ones
<br /> SUBSCRIBED in my presence and sworn to before me this 27th
<br /> day of February, 1978.
<br /> Lorine F.Mares �,��`�/- �� y�j
<br /> � � �6£N6RAL NOTARfAL <� ,�lCJ!/Ll���G w� �//��'�''��
<br /> S��L Notary Public
<br /> : 6TATE�AF.NE8RA9KA
<br /> � ' � OOMMISSION 6%P1RCS . � `
<br /> SEAL AuBust 1, 1981 •
<br /> ; -
<br /> : . �
<br />
|