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NDOL Serial No.: <br />LAB -0048 -2018 <br />To be filed with the Re: ister of Deeds in the followin Counties: <br />NDOL Acct. No.: <br />0312448005 <br />Hall <br />01/2012 <br />5/31/2018 <br />Federal ID No. / SSA No.: <br />xxx -arx -2333 <br />$644.17 <br />$1,228.27 <br />Qtr. / Yr. <br />Date Assessed <br />Combined Tax Or Payment In Lieu <br />Of Contributions Due <br />Penalty <br />Interest <br />Through <br />6/15/2018 <br />Subtotal <br />01/2012 <br />5/31/2018 <br />$584.10 <br />$0.00 <br />$644.17 <br />$1,228.27 <br />$ 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 />$ 0 -00 <br />$ 0.00 <br />TOTAL Combined Tax or Payment in Lieu of Contributions Due (under this lien only): <br />$1,228.27 <br />Jun, 20. 2018 3:04FM NE Secretary of State <br />b <br />STATE TAX LIEN a NEBRASKA DEPARTMENT OF LABOR <br />■ ORIGINAL <br />Date: June 20, 2018 <br />Employer or <br />Liable Person: Jesus Castaneda dba J C Welding <br />Address: 535 E Capital Grand Island NE 68801 <br />T:\ DOCC .IMENTS\FORMS\Liens \0riginal lien.docx <br />RETURN FILED COPIES TO: Nebr. Dept. of Labor - LEGAL <br />P.O. Box 94600 <br />Lincoln, NE 68509 -4600 <br />201803948 <br />By: <br />'1IE Soo of 'Bain John a If. le - UCC 511. <br />111 11 I <br />■ <br />9918814129 -0 r NIB: 1 <br />CRSTRNEOR JESUS <br />Filed 06/20/2018 09 :28 RR <br />N.. 0495 <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 far unpaid combined taxes (Neb. Rev. Stat. §148151 and 48 -664) or payments in lieu of contributions (Neb. Rev Stat. 048- 660.01) pursuant to <br />the Uniform State Tax Lien Registration & Enforcement Act (Neb. Rev. Stat. §77 -3901, et 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 />JOHN H. ALB1N <br />Commissioner of Labor <br />KATIE <br />XE S■ R, Agency General Counsel <br />THOMAS A. UKINSKI, Legal Counsel <br />LIBBY ELDER, Attorney <br />NEBR. DEPT. OF LABOR <br />CHARGE ACCT. #14765 <br />A , <br />