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NDOL Serial No.: LAB-0016-2018 <br />To be filed with the Re. ' ter of Deeds in the followin _ Counties: <br />NDOL Acct No.: ; 0288410005 <br />Hall <br />Interest <br />Through <br />312/2018 <br />Subtotal <br />Federal ID No. / SSA No.: : ,cxx- x-4972 <br />2/14/2018 <br />$153.77 <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 />312/2018 <br />Subtotal <br />02/2017 <br />2/14/2018 <br />$153.77 <br />$0.00 <br />$16.22 <br />$169.99 <br />03/2017 <br />2/14/2018 <br />$108.15 <br />$0.00 <br />$6.50 <br />$ 114.65 <br />04/2017 <br />2/14/2018 <br />$0.00 <br />$0.63 <br />$ 4334 <br />1111111111111111 <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 />$0.00 <br />TOTAL Combined Tax or payment in Lien of Contributions Due (under this lien only): <br />$ 327.98 <br />Mar 7. 2013 4:16PM NE Secretary of State — UCC <br />STATE TAX LIEN ❑ NEBRASKA DEPARTMENT OF LABOR <br />• ORIGINAL <br />Date: 3/6/2018 <br />Employer or <br />Liable Person: Ronald V.1Zath'en <br />Address; 1504 W Ave. Grand Island, NE 68801 <br />T :IDOCUMeN TSWORMS\Liens \Original lien.docx <br />RETURN FILED COPIES TO: Nebr. Dept. of Labor - LEGAL <br />P.O, Box 94609 <br />Lincoln, NE 68509 - 4600 <br />By: <br />0 18 O 1 4 0 7 <br />I Sec of sale <br />No. 3620 F. <br />John l o•1. - UGC <br />1 <br />9918807276 -2 F <br />RATHJEN RONALD V. <br />Filed: 09/07/2019 02;24 PM <br />5 <br />9s; 1 <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 Tax Lien is issued for unpaid combined taxes (Neb. Rev. Stat. §148 -657 and 48 -664) or payments in lieu of contributions (Neb. Rev. Stat. §48- 660.01) pursuant to <br />the Uniform State Tax Lien Registration & Enforcement Act (Neb. Rev. Stat. §77 -3901, er seq.). Notice is given that combined taxes or payments in lieu of contributions, <br />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 payments in lieu of <br />contributions constitute a lien for any and all personal property and real property in the county /counties named, belonging to the employer or person, whether now owned or <br />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 />JOIN R ALBIN <br />Commissioner of Labor <br />KATIE S. TIMBER, Agency General Counsel <br />THOMAS riv UKINSKI, Legal Counsel <br />LIBBY ELDER, Attorney <br />NEBR. DEPT. OF LABOR <br />CHARGE ACCT. ##14765 <br />