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06/16/2005 08:15 FAX 14024714429 NEBRASKA UCC IM002 <br />%7 <br />200505425 <br />STATE TAX LIEN • NEBRASKA DEPARTMENT OF LABOR <br />X ORIGINAL <br />STL <br />990'3399468 -7 Pas: t <br />RITTER BOBBI <br />Filed: 06/16/2005 02:42 PM <br />NDOL Office of Legall <br />P.O. Box 94600 <br />Limcoln, NE 685094600 <br />Telephone - (402) 471 -9912 <br />FAX - (402) d71 -9b17 <br />bmployer -Name: Bobbi Ritter f/d/b /a Flight Deck Restalzrant8t Lounge <br />Address: 1302 Sherman Street St_ Paul NE 68873 ` -- <br />NDOL Serial No.: j LAB- 0087 -2005 To be filed with the Register of Deeds in the following Counties: <br />NDOL Employer Acct. No.: 0295308008 Howard Hall <br />�Federal ID No.1 SSA No.: 48- 12651-02 <br />This State Talc Lien is issued for unpaid combined taxes (Neb. Rev. yStat 48-657 )or <br />to the Uniform State Tax Lien Registration & Fnforcement Act (Neb. Re §Stat § 77- 3901met se Notice �s maven that (Neb. <br />ombm t� §or 860.01) pursuant <br />contributions, interest (computed at 1.5% per month), 4 } payments in lien of <br />p } penalties are due from this employer and remain unpaid after demand These combined taxes or <br />payments in lieu of contributions constitute alien for any and all personal property and real property in the county /counties named, belonging to the employer, <br />whether now owned or hereafter acquired <br />Qtr. / Yr. I Date Assessed <br />1r2uu4 5/17/2005 <br />2/2004 5/17/2005 <br />Combined Tax Or payment In Lieu <br />Of Contributions Due <br />$14623 <br />$ia0.o0 <br />TOTAL Combined Tax or Payment in Lieu of Contributions Due (under this lien only): <br />Interest <br />Penalty I Through <br />F 6/1/2005 <br />$25.00 1 $28.62 <br />$25.00 r $21.05 <br />Subtotal <br />$ _199.85 <br />$ 1.86.05 <br />$ 0.00 <br />_ $ 0.00 <br />_$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />$ 0.00 <br />$ 000 <br />$ 0.00 <br />$ 0.00 <br />$ 385.90 <br />I certify that the Nebraska Department of Labor has complied with the <br />Employment Security Law of the State of Nebraska in the <br />determination of the amount due, and the employer has failed to pay the amount due after demand. <br />FERNANDO LECUONA, M <br />• Commissioner of Labg>� —� <br />Date' June 15, 2005 By: <br />IOHN H. ALB -or- THOMAS A. UiQNSKI <br />Agency Legal Counsel Legal Counsel <br />RETURN FILED COPIES TO. Nebr. Dept. of Labor - LEGAL NEBR DEPT. OF LABOR , <br />P.O. Box 94600 x. <br />CHARGE ACCT. #147G5,,��. <br />