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08/18/2005 09:35 FAX 14024714429 NEBRASKA UCC 0002/002 <br />IN <br />200508061 <br />STATE TAX LIEN • NEBRASKA DEPARTMENT OF LABOR <br />X ORWINAL <br />Employer Name: Guy Schott +d /b /a The Gutter Guy - <br />�� Address: 613 W. 8`b Street Grand Island NE 68801 <br />NDOL Serial No.: I LAB -0118 -2005 <br />NDOL Employer Acct. No.: 1 0289949001 <br />Federal ID No. / SSA No.: 1 47- 0842313 <br />NR Sic of Si�io - UM STL <br />e ®054083334 Pas: 1 <br />sCHOTT GUY <br />Filed: 68/17/2005 12:07 PM <br />NDOL Office of Legal counsel <br />P.O. Box 94600 <br />Lincoln, NE 68509 -4600 <br />Telephone - (402) 471 -9912 <br />FAX - (402) 471 -9917 <br />To be filed with the Register of Deeds in the following Counties: <br />This State Tax Lien is issued for unpaid combined taxes (Neb. Rev. Stat. §48 -657) or payments in lieu of contributions (Neb. Rev. Star §48- 660.01) pursuant <br />to the Uniform State Tax Lien Registration & Enforcement Act (Neb. Rev. 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 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 property and real properly in the county /counties named, belonging to the employee', <br />whether now-owned or hereafter acquired <br />Qtr. / Yr. <br />Date Assessed <br />Combined Tax Or Payment In Lieu <br />Of Contributions Due <br />Penalty <br />Interest - <br />Through <br />7/28/2005 <br />Subtotal <br />1/2002 <br />2/2002 <br />3/2002 <br />T�4/2002 <br />7/13/2005 <br />7/13/2005 <br />7/13/2005 -- <br />$52.50 <br />$52.50 <br />$52.50 <br />$52,50 <br />$25.00 <br />1 $25.00 <br />$25.00 <br />-_� $25.00 <br />$30.67 <br />$28.29 <br />$25.91 <br />$ 108.17 <br />-� - - -$ 105.79 <br />_ $ 103.41 <br />23.53 <br />_�- $ 101.03- <br />$ 0.00 <br />- -- - -� <br />- <br />- <br />- -- <br />0.00_ <br />$ 0:00_ <br />$ -SAO <br />0.00__ <br />S 0.00 <br />TOTAL Combined Tax or Payment in Lieu of Contributions Due (under this lien only): i $ 418.40 <br />I certify that the Nebraska Department of Labor has complied with the 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 />Date: August 17, 2005 <br />RETURN FILED COPIES TO: Nebr. Dept. of Labor - LEGAL <br />P.O. Box 94600 <br />T.inrnln. NN 69.S09 -"flfl <br />FERNANDO LECUONA, III <br />ragat-91N -or- THOMAS A. UIUNSIa <br />Legal Counsel Legal Counsel <br />NEBIL DEPT. OF LABOR <br />CHARGE ACCT. #14765 <br />