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Qtr. /'Yr. <br />Date Assessed <br />Combined Tax Or Payment In Lieu <br />Of Contributions Due <br />Penalty <br />Interest <br />Through <br />3/2/2018 <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 />$42.71 <br />$0.00 <br />$0.63 <br />$ 43.34 <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />--., <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />TOTAL Combined Tax or Payment in Lieu of Contributions Due (under this lien only): <br />$ 327.98 <br />Mar. 7. 2018 4:17FM NE Secretary of State ā€” UCC <br />STATE TAX LIEN ā‘ NEBRASKA DEPARTMENT OF LABOR <br />ā–  ORIGINAL <br />Employer or <br />Liable Person: <br />Address: <br />NDOL Serial No.: <br />NDOL Acct. No.: <br />Federal ID No. / SSA No,; <br />Date: 3/6/2018 <br />LAB - 0018 -2018 <br />0288410005 <br />47- 0838173 <br />T :\ DOCUMENTS \FORMS \Licns\Original lien. docx <br />Rath - en & Son Ente . ises, Inc. <br />1504 W Ave. Grand Island, NE 68801 <br />RETURN FILED COPIES TO: Nebr. Dept. of Labor - LEGAL <br />P.O. Box 94600 <br />Lincoln, NE 68509 -4600 <br />To be filed with the R ister of Deeds in the following Counties: <br />Hall <br />By: <br />201801409 <br />Nā–  Coo .0 C4e4. John A OMR - UCC ST <br />9918807278 -6 Pe:: 1 <br />RgTNJEN ti SON ENTERPRISES, INC <br />Filed: 03/07/2010 02 :24 PM <br />No. 3623 P. 5 <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 Len is issued for unpaid combined taxes (Neb. Rev. Seat § §48 -657 and 48 -664) or payments in lieu of contributions (Web. Rev. Sea. §48- 660.01) pursuant to <br />the Uniform Stale Tax Lien Registration do Enforcement Act (Neb. Rev. Seat §77 -3901, et seq.). Notice is given that combined takes 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 />KATIE S, 1' UBBER, Agency General Counsel <br />THOMAS A. UKI,NSKI, Legal Counsel <br />LIBBY ELDER, Attorney <br />NEER. DEPT. OF LABOR <br />CHARGE ACCT, #14765 <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 />JOHN I. ALEIN <br />Commissioner of Labor <br />