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STATE TAX LIEN ❑ NEBRASKA DEPARTMENT OF LABOR NDOL Legal Division <br />P.O. Box 44600 <br />Lincoln, NE 68509 -4600 <br />■ CONTINUATION Telephone - (402) 471-9912 <br />FAX - (402) 471 -9917 <br />Employer Or <br />Liable Person: <br />Tom Ellison f/ci/b /a Ellison Entcrpris <br />Address: <br />311 West 15a Street Grand Island NE 68801 <br />NDOL Serial No.: <br />LAB -0002 -2005 <br />To be filed in the State <br />Resister of Deeds in <br />Hall <br />Tax Lien Register maintained <br />the following Counties: <br />_ <br />by the <br />Document Piling No: <br />-, <br />9905369483 -3 <br />NDOL Acct. No.: <br />0280444007 <br />Federal ID No. / SSA No.; <br />47- 0802022 <br />COUNTY: <br />COUNTY FAG NO.: <br />DATE FILED; <br />ADDITIONAL INFORMATION (if applicable): <br />Hall <br />0805000130 <br />January 3, 2005 <br />Orig. Filed Co 01/06/2005 @ 8:19 # 0200500150 <br />Oct. 3, 2014 3:13PM NE Secretary of State — UCC No. 7040 P. 4 <br />This is a CONTINUATION of an existing lien and serves to coutiaue the lien and priority of the Nebraska Department of Labor <br />on the affected property of this employer or liable person. This CONTINUANCE is filed pursuant to Neb. Rex Slat § §48 -657 <br />and 48-664 and the Uniform State Tax Lien Registration & Enforcement Act (Neb. Rex Stat. §77 -3901, etseq.). <br />The following lien shall be continued for a period of ten years. <br />T certify that the Nebraska Department of Labor has complied with the Employment Security Law of the State of Nebraska in <br />the determination of the amount due, and the employer or person has failed to pay the amount due after demand. <br />Date: October 3, 2014 <br />T: IDOCUWENTS1 1:ORMSU.iens1Coaonuation.docx <br />RETURN FILED COPIES TO: Nebr. Dept. of Labor -LEGAL NEBR. DEPT. OF LABOR <br />PO Bo* 94600 <br />Lincoln NE. 68509 -4500 <br />20144)6304 <br />By: e <br />JOHN D. ALBIN <br />Acting Commissioner of Labor <br />Ill <br />311m of Sk.lr J.hr, Gale - uCE %CoN <br />US1474411a -7 Ploe: 1 <br />eLLISON TOM <br />Filed. 1/03 /2014 02,25 PM <br />THOMAS A. mama, Legal Counsel <br />KATIE S. THURBILR, Legal Counsel <br />CHARGE ACCT. #14765 <br />