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1 ','/04,, '1002 17:10 FAX 14024714429 <br />VU <br />NEBRASKA UCC <br />2002125213 <br />STATE TAX LIEN • NEBRASKA DPARTwN7, OF LABOR <br />X Olurvist, <br />D002/002 <br />I^e <br />'4 P, I <br />,M,L '. I <br />IU02 11 IS <br />M.' 7 IANM <br />NDOL Office ofLegal Counsel <br />P.O. Box 94600 <br />Lincoln, NE 685094600 <br />Telephone - (402) 471-9912 <br />Employer Nsam: Eh,=m1. C..a . t.x.iwrsJ�, <br />.. ..... ... -- I ... ........a <br />.......... . ........ . ........... ...... <br />Address: B..2042G.dIslxadNTE688)2 <br />NDOL Serial No.; LAB�03062002 To be filed With the Register of Deeds in the following Counties: <br />.......... ... . . . ....... . ............. ..... .......... I ...... ...... ............ . ............ .... <br />NDOI. Employer Acct. No.: 020303008 Hall <br />. ...........I - -. . ... ......... .......... ........... ... . ... .... .......... ... ......... . : ......... .. .. .... .... ... ......... ............ .. .... ... ... <br />Federal ID No. / SSA No.: 47-0667162 <br />This Stain Tax LimislsmMforunpaidemnblmdta (Neer.Rev.Sins §48-657)mp"wft in Jim (Neb. Rev. Staii §48-660.01) pursuant <br />W the T-Iii,fortn Statte Tax Lim Rccstrxbm & E.fcoinciat Art (M6. Rs, Sou. §77-3901, etcq) 'Tetiec is given th. coribmed t.es or payments is list, <br />,,,fWambatims, ictasst (computed ati5 % Par ismai), and penaTfics xic due from this ca,,hcr aud,ex,.in unpaid aft. drutard. These rombasirazes <br />x paymevs io lids of contributions n0utllute a lien {or anY sad all pcaeonal Property end real propmty u the county /mandm named, belmtging ro rile <br />......... .. .... . ...... ... ..... ..... .... ..... . . ...... .... ...... ... .. <br />..... . ... <br />Combined Tax or i <br />$...... 0.06 <br />Interest <br />... . .. <br />Qtr. / Yr. <br />Date Assessed <br />Payment In Lim Of Contributions Due <br />Penalty <br />through <br />Subtotal <br />FERNANDO LECUONA HE <br />j <br />IM7002 <br />'1002 <br />Nov. 13 2002 <br />$ <br />54K97 <br />0.00 i <br />7..5.. 44 i S <br />5,024.41 <br />. .... ........4, <br />. ..S .. <br />...... I . ...4... .... <br />NEBR. DEPT. OF LABOR <br />P.O. Box 94690 <br />......1..._....... <br />Li.,d,.NT 69909-4600 <br />... ....... . <br />. .. ................... . ........... . ......... <br />............ . ....... <br />........ ......... ... . <br />....... . . <br />. ... . ..x... <br />.... . . . <br />$ <br />0 ro <br />. ...... <br />........... . .... <br />... ..... ... <br />.. ..... .............. .. .. ...... ..... ...... 1- .... ...... ......... f <br />........ <br />i $ <br />.. ........ .... .. ... ....... -.— <br />OBC <br />. ...... . . ........ <br />......... <br />. ...... - ......... ---q ..... <br />....... . - ------ <br />--- <br />.. . ........ ............ <br />........ . ... ........ <br />.... ........... ... I . . ......... <br />. . ............ ..... ....... . .. .. ..... ..... .......... . . <br />0-00 <br />a. <br />............... ........ . ... <br />$ <br />C.00 <br />..... . ..... <br />..... . ............ ............ . ....... .. -1.1 .. . ... ...... ......... <br />... <br />..... <br />..... ...... <br />w <br />$ <br />000 <br />......... .. .... . ...... ... ..... ..... .... ..... . . ...... .... ...... ... .. <br />..... . ... <br />.... .. <br />$...... 0.06 <br />.. ... ..... ... I . ..... .... . ......... <br />... . .. <br />$ OM <br />TOTAL Combined Tax or Payment to Lien of Coatribisdons, Dae (under this heix only): <br />5,024.41 <br />1 certify that the Nebraska Department of Labor has compiled with the Employment Security Last of the Slow of Nebraska In the <br />determination of the amount due, and the employer has failed to pay the assumat due after demand. <br />FERNANDO LECUONA HE <br />Constabsionsr of Lab, <br />Date Drrxba,T <br />2002 By: <br />JO <br />Ageni Counsel <br />THOMAS A. UV—NS1C[ <br />Legal counsel <br />RETLRN FILED COPIES TO: Nebr. Dept. of Labor - LEGAL <br />NEBR. DEPT. OF LABOR <br />P.O. Box 94690 <br />CHARGE ACCT. 41476 <br />Li.,d,.NT 69909-4600 <br />