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12/22/2004 18:08 FAX 14024714429 NEBRASKA UCC <br />)q <br />20041Z2�ry . <br />IA 003/008 <br />STATE TAX LIEN • NEBRASKA DEPARTMENT OF LABOR NDOL Office of Legal Counsel <br />P.O. Box 94600 <br />X ORIGINAL Lincoln, NE 68509 -4600 <br />Telephone - (402) 471-"12. <br />FAX - (402) 471 -9917 <br />Employer Name: Armandos Construction Inc. <br />Address 812 East 5* Street Grand Island NE 68801-2712 <br />NDOL Serial No:; I LAB- 0224 -2004 <br />To be filed with the Register of Deeds in the following Counties: <br />NDOL Employer Acct. No.: 0292058000 <br />Hall <br />Federal ID No. / SSA No.: 1. 47- 0836184 <br />This State Tax Lien is issued for unpaid combined taxes (Neb. Rev. Stat. <br />48 -657) or payments in lieu of contributions (Neb. Rev. Stat. §48- 660.01) pursuant <br />to the Uniform State TaxLien Registration &Enforcement Act (Neb. Rev. <br />Stat. §77 -3901, etseq.). Notice is given that combined taxes or payments in lieu of <br />contributions, interest (computed at 1.5% per month), and penalties are due <br />from this employer and remain unpaid after demand. These combined taxes or <br />payments in lieu of contributions constitute a lien for any and all personal <br />property and real property in the county /counties named, belonging to the employer, <br />whether now owned or hereafter acquired. <br />Combined Tax Or Payment <br />In Lieu Interest <br />Qtr. / Yr. Date Assessed <br />Of Contributions <br />Penalty Through i Subtotal <br />Due <br />I2/I612004 <br />3/2001 <br />12/1/2004 <br />$312.02 $0.00 $175.67 $ 487.69 <br />4/2001 <br />12/1/2004 - - <br />$95.13 $25.00 $49.24 $ 169.37 <br />1/2002 <br />12/1/2004 <br />Ii i <br />$91.60 ' $25..00 � $43.400 $ 160.00 <br />i <br />2/2002 <br />12/1/2004 <br />I $68.71: $25.00 $29.44'1 $ 123.15 <br />3/2002 <br />12/1/2004 �- _� <br />$24.57 - $25.00 $9.41 i $ 58.98 <br />4/2002 <br />12/1/2004 <br />�� <br />$50.14 I $25.00 $16.93 j $ 92.07 <br />1/2003 <br />12/1/2004 <br />$0.00 $25.00 0 $ 25.00 <br />I i $ 0.00 <br />I -- i $ 0.00 <br />- <br />u 0.00 <br />$ 0.00 <br />TOTAL Combi6d <br />Tax or Payment in Lieu of Contributions Due (under this lien only): $1,116.26 <br />I certify That fire <br />Nebraska Department of Labor has complied with the Employment Security Law of the State of Nebraska in the <br />determination <br />of the amount due, and the employer has failed to pay the amount due after demand. <br />FERNANDO LECUONA, MIn <br />C fission f La <br />Date: Decem <br />22, 2004 By: V <br />AL -or- THOMAS A. UKINSKI <br />A cy Legal Counsel Legal Counsel <br />�e <br />RETURN FILED <br />COPIES TO: Nebr. Dept of Labor - LEGAL NEBR. DEPT. OF LABOR <br />GE ACCT. #14765 <br />P.O. Box 94600 <br />i,inrnh_ NF. fdlri119 -d(dID <br />01 <br />