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12/06/2002 <br />17.49 <br />C..bid Tax or <br />F4X <br />14024714429 <br />-NEBRASKA <br />UCC <br />—1 <br />A <br />C) <br />Date Assessed Payment In Urn Of Contributions Due <br />Penalty <br />through <br />Subtotal <br />200213627 <br />IA002/002 <br />Lmso Gssn, <br />i I.d 210MI2082 02 lt PM <br />STATE TAX LIEN@ NEBRASKA DEPARTNIENT OF LABOR NDOL Office oflegal Counsel <br />P.O. Box 94600 <br />Liusel, NT 69509-4600 <br />Telephone- (402)471 -9912 <br />FAX- (402) 471 -9917 <br />.... .... ........ . uw ........ . . ................. . ...... . . ..... ..... .. ....... ... ........... .. . ......... . ... ..... . . <br />Address: 205 U. Hwy *2 Coro M 68824 <br />.... .. SDOL Serial No.: LAB-0324-2002 To he tiled with the Register of Deeds in the following Counties: <br />..... . .............. ... <br />NDOL Employer Atm. Nn.: 027519100 Hail <br />.... . ................................ ............ ....... I ..... . ......... .. .. ........ ....... ........... . <br />Federal lD No. / SSA No.; 47 0816224 <br />TL '.aS[ete:axLinviaissucd:ormpaid combined coxes (.Neb.Ra,.,frac X48- 557)erpaymevrin lieu cfmvaibuucea (Nab. Rev. Srer. ¢43b60.01)pmavant <br />w the Uniform Smw 7az Lirn Registrvtiun & F.forcreao Act (.Yeb. Rev. Smr. 477 -3901, eraegJ. NuOrx is gium Matcombined rxa orpaymenn in lieu <br />ofcontribudoiis, imam (compuwdatl5% per mondi),.dpm,:L. are due nom thus -V'O,cr and l.-.i. unpaid after demand. These combined taxes <br />L,rpaymcras in lieu of contributors c tftulc a lien for any vrd.11 personal plpeny and real prn,.ny in the or.otc..dee rannd, bcl..gig toth, <br />.player, nhorntr now owned or hscaft. acquired <br />I cerd[v that the Nebraska Department of Labor hat COMPlied with the Employment Security Law of the Store of Nebraska In Me <br />dreortumation of the amount due, and the employer has fulled to pay the amount due after demand, <br />Dote. December 6, 2002 <br />RETT RN k I I I I COPIES TO: Nebr. Dept. ul Labor - LEGAL <br />P.O. Be. 94600 <br />Lir,.1, NE 681109� <br />FERNANDO LECUON9, at <br />Connote lose fLb. <br />1y( l`rr! �lGl /r /A/ <br />- -or- THOMAS A. UKENSKI <br />04 y Co.: el Legal Counsel <br />NFRV DEPT. OF LABOR <br />cigAncv: ACCT. #14765 <br />C..bid Tax or <br />Interest <br />Qtr. /Yr. <br />Date Assessed Payment In Urn Of Contributions Due <br />Penalty <br />through <br />Subtotal <br />1 <br />1210412002 <br />1/2001 <br />Nov. 19, 2002 i $ P7.62 S <br />0.00 <br />i $ <br />28.06 S <br />115A9 <br />... ... .... <br />22001 <br />... ... . . <br />Nov 19, 2002 1 S 1 <br />...................... <br />0.00 <br />� $ <br />27.65 <br />14189 <br />3/200t <br />r <br />... . . ........ ......... . <br />Nov, 19, 2002 i 125.87 S <br />. . ......... <br />0.00 <br />................ <br />! $ <br />.................. .. . ..... <br />24.76 <br />.......... ... ........ <br />150.63 <br />4/2001 <br />.... . .... ... . . . .......... .................. <br />Nov. 19, 200' $ 26.51 $ <br />A <br />.... . ....... <br />000 <br />... ....... <br />j $ <br />...... - ....... . . .. <br />4.03 i $ <br />.. .... ... .. . . ...... <br />30.64 <br />........ . .. <br />.... <br />...... . ...... . ...... .... ......................... .. . <br />. . . ......... ... <br />....... <br />I-- .. ...... ... . ... ............. <br />. .... ... . <br />.... <br />......_...i. .... <br />i <br />. <br />. S <br />.. ......... .... ............ <br />� 0.00 <br />. ...... ....... <br />. .......... i . .............. ..... ......... .......... . ... . ... . . ...... .. .. <br />......... . .. <br />.......... ... . ..... ....... <br />00 <br />$ <br />0,00 <br />........... <br />... <br />. .......... .. .. . ...... <br />.. ................. <br />......... <br />.................. .... <br />..... . ......... ..... i.- ......... ... . ; ... <br />S <br />0.01, <br />... ... . <br />. .. ........ <br />.... ........ . <br />00 <br />...... .......... ...... . ... . ................. ....... .... <br />.............. ..... <br />.... . ............ .... <br />. ........ ... <br />TOTAL Combined Tex or Payment In Lien of Contributions Due trader Mh lien only): <br />($ <br />449.84 <br />I cerd[v that the Nebraska Department of Labor hat COMPlied with the Employment Security Law of the Store of Nebraska In Me <br />dreortumation of the amount due, and the employer has fulled to pay the amount due after demand, <br />Dote. December 6, 2002 <br />RETT RN k I I I I COPIES TO: Nebr. Dept. ul Labor - LEGAL <br />P.O. Be. 94600 <br />Lir,.1, NE 681109� <br />FERNANDO LECUON9, at <br />Connote lose fLb. <br />1y( l`rr! �lGl /r /A/ <br />- -or- THOMAS A. UKENSKI <br />04 y Co.: el Legal Counsel <br />NFRV DEPT. OF LABOR <br />cigAncv: ACCT. #14765 <br />