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<br /> � SEC�Y SiA��
<br /> STAT�TAX LIEN • NEBRA9K�►D�PARTM�NT OF LABOR ND�L Legal Division
<br /> I'.O.Box 9460�
<br /> . Lit�c�ln,NE 68SQ4-4600
<br /> X O�a11�AL Telephone-(482)471-9912
<br /> FAX-{402}�71-991T
<br /> Employer Namec TODD WHIT2,doing busineas as:'aVF�ITE K1�IGHT SECt3RITY.SP.RVICE....... ..................... ............................. ....................
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<br /> Address: F.O.Box 507,Crrand Islsnd,NE 68802
<br /> NDQL 3eri�1 NQ.: LAB-034b-199� To be filed�vith ths Register oe Deeds in the Pollowing Connties:
<br /> NDOL Emplayer Acct.No.;.....0255787Q03...... .................... .. ..Hall.....�,,..,..,........,,.,,.,,.q................... .............,,......,, ' .......,...,....,.,. ,.....,....,.,.....,,
<br /> ...................... ................ .................... ........................................................... .............. .,�.. ..:..
<br /> �'od�tal ID No./S�A No.: 4ti-0790321
<br /> 'fi'ts Staee Ta�c Lien is issued for unpeid combined taxes(�'sb.Rgv.5tat �48•637)or paymants in lieu af oontributions(Neb.Rev.Stat. §48-560.01)putsuazlt
<br /> to thd UniEorm State'1'�x Lian Regsstration&Enforcert►ettt Aet(N�b.Re�,Seat. §77-3901,ea seg.). Notiee is given that combiaed t�xes ar paymeats in:ieu
<br /> of�ontributions,interest(comput�d�1,5%pCr moAth),and panalties are due from this employer and rem�ia unpead�Rer demand. 'These combined taaces
<br /> or p�ymenta in li�u of aon�bukion�consticute a lien far aay snd ali peraon�l property and reat prognrty i�rhe counry!cauntieg named,belon�ing to zhe
<br /> �mpibysr,whether now owned oz here3f�e�r�Cquit�d.
<br /> ` ; Combened Tax or � ` `
<br /> Qtr./Yr. ° Date Asiessed ; Payrnet�t In Lieu Of Contributions g Interest � Penalty ; Subtatal
<br /> Due s �
<br /> � . 284.49 : $ 64.52 ; $ 25,00 : � 374.01
<br /> 2•1998 ~ 11•3-99 s $ .. � ........ .... .. ., .......,..... ,. Q , ..,..,.., ....... .
<br /> ............3-1998.......,,,.;�.,..,.....11-3-99.....,,,..�...�..................................................................182,b3...�,,.$'........... 33,13...i...�'.,........ 0.00 ` $ .,,,.... ,.. �,�5.'76 .
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<br /> ,.,.,.� ,,,, ........... ......................................................................................:. .. ..40.82. ..$., ..�5.04 : $ 365.�2'.
<br /> ....., ....,4-199$ : 11-3-99 ; � 360,40 $ ,, ..,, . : . .......... ......... �
<br /> , ..4.......................................
<br /> .,,.,.,.,,�•1-1999..... ...i....,.....,i.1.3�g�,,, ....,;.,,�........ ....................................... .............�OO.Oa. ..$.....,,, ..,27,66...'...$...,,,...... 25.00 ` � .......... 352.66 ..
<br /> ............'�1999....,., ......,,i.1-3yQ9...,, , .e,..�....... ..................... ..............................300.04.,:.,.$,.. , , 14.05� :..�,............ 23.00. ..�,......,...... 339.C�5 ..
<br /> ..........,.3-1999......... .........�,1_3�9�..,,..,.,..�...$......,...... .................,,, ,...............,, .....,,3,40;00,. ;,.�................�:4�,; ;..�...,..........�S:Ob...c...$'...,, .......�23.44 ..
<br /> .....................�,� ,.,,,..., .....,....,......, ,............�5... ....................,,,..,.,,....,...�,r ...,.,,.,,..,. ,.i.. � ..$.. ..•O.00..
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<br /> ...... ................................... .............................R...,., ........................,.........,.., ...........,..... ' $ 0.00
<br /> ............................. .....s..,,.... ,...,...,,........, ... � ........,..........,...,.,.,�.,..,.........,,.,, ,,.,,,.,,...,....., .,..,,.,,. � . . .,............... ......i...........,.,..,........,...,,.�,..$...,...,, .........0.00....
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<br /> TOTA,L Combined Tiax br Payment tn.Lieu of Gantributions Uue(ander this lien oely): ' � ��97�'��
<br /> I eertify that the Nebr�sfta Depaxtment of Labor has camplied with the�mployment 5�curity Law of the State of;��br�ska in the
<br /> determie$tion of the amouat due,and the emptayer has failed ta pay the amount due after demand,
<br /> F�12NANDd LECUONA,IiI
<br /> Cammissioner Labor
<br /> Date: December 1�4, 1999 �y' -or- JOHN I�.ALBY.�1
<br /> J .S�I ,
<br /> A en Legal Counsel Legaf Counsel
<br /> NESR.DEPT.OF�.ABOR
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