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06/29/2005 16:14 FAX 14024714429 NEBRASKA UCC IM002/007 200505917 5XHUST INC. 02: A 23 Pli STATE TAX LIENO NEBRASKA DEPARTMENT OF LABOR NDOL Office of Legal Counsel P.O. Box 94600 X ORIGINAL Lincoln, NE 68509-4600 Telephone - (402) 471-9912 FAX - (402) 471-9917 Employer Name: Midwest Muffler & Exhaust Inc. d/b/a MidwestSports & Imports Address* 2204 W. 2"d Street Grand Island NE 68801 NDOL Serial No.: LAB-0096-2005 To be filed with the Register of Deeds in the following Counties: NDOL Employer Acct. No.: 0304367004 Hall — ------------------- ------- Ti&_r2l ID No. / SSA —..N..'.o-..:7--5-2973107 This State Tax Lion is issued for unpaid combined taxes (Neb. Rev. Stat. §48-657) or payments in lieu of contributions (Neb. Rev. Siat §48-660.01) pursuant to the Uniform State Tax Lien Registration& Enforcement Act (Neb. Rev. Stat. §77-3901,efseq,). Notice is given that combined taxes or payments in lieu of contributions, interest (computed at 1,5% per month), and penalties are due from this employer and remain unpaid after demand. These combined taxes or payments in lieu of contributions constitute a lien for any and all personal property and real property in the county/counties named, belonging to the employer, whether now owned or hereafter acquired. Qtr. / Yr. Date Assessed I Combined Tax Or Payment In Lieu Of Contributions Due Penalty Interest Through 6/15/2005 Subtotal 1/2003 5/31/2005 $174.94 $0.00 $67.01 $241.95 2/2003 5/31/2005 $256A9 $0.00 $86.52 $342.71 3/2003 5/31/2005 $227,93 $66-64 $ 294.57 4/2003 5/31/2005 $408.28 .00 $100.84 $509.12 04 .................. 5/31/2005 . .. . .. . ... ...... ......... $771.57 $0.00 . . ..... .... $156.34 '$ 927.91 $572,64 $0.00 $90-06 $662.70 04 5/31/2005 $62.50 $ 620.94 4/2004 . ..... ........ 5/31/2005 $715.62 $47.63 $763.25 . ........ $ 0.00 $ 0.00 0..00 0.00 TOTAL Combined Tax or Payment in Lieu of Contributions Due (under this lien only). 14,313.15 I certify that the Nebraska Department of Labor has complied with the Employment Security Law of the State of Nebraska in the determination of the amount due, and the employer 112S failed to pay the amount due after demand. FERNANDO LECUONA. Date: —June 29, 2005 By: 4 H. ALBIN -or- THOMAS A. UXINSKI Legal Counsel Legal Counsel RETURN FILED COPIES TO. Nebr. Dept of Labor = LEGAL NEBR. DEPT. OF LABOR P.O. Box 94600 CHARGE ACCT. #14765 Tilmmin.NF, 6k509-4100 ?6.