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<br />01/31/2007 17:47 FAX 14024714429 <br /> <br />NEBRASKA Dee <br /> <br />III 002 <br /> <br />200700809 <br /> <br /> <br />STL <br /> <br />\J <br /> <br />9907493291-1 pss: 1 <br />~ ,F GRRND 16LAND INC <br />Flled, ~1/31/2Dm7 11,08 AM <br /> <br />STATE TAX LIEN 0 NEBRASKA DEPARTMENT OF LABOR <br />8 ORIGINAL <br /> <br />NDOL Office of Legal Counsel <br />P.O. Box 94600 <br />Lincoln, NE 68509-4600 <br />Telephone -' (401) 471-9911 <br />FAX - (401) 471-9917 <br /> <br />Employer Name: M F Grand Island Inc fdba Mickey Finn's Sports Cafe <br />Addreu: J 2808 Old Fair Road, Grand Island, NE. 68801 <br /> <br />NDOL Serial No.: LAB-0039-2007 To be filed with the Register of Deeds in the following Counties: <br />NDOL Employer Acct. No.: 0271583005 Hall <br />Federal ill No.1 SSA No.: I 47-0807167 <br /> <br />This State Tax Lien is issued for unpaid combined taxes (Neb. Rev. Stat. ~8-(57) or payments in lieu of contributions (Neb. Rev. Stat. ~48-660.01) pursuant <br />to the Unifonn State Tax Lien Registration & Enforcement Act (Neb. Rev. Stat. ~ 77- 390 I, et seq.). 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 contn"butions constitute a lien 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 /> <br /> , . Interest I <br />Qtr./Yr. Date Aliliessed Combined Tax Or Payment In Lieu Penalty Through Subtotal <br /> or ContributioDs Due 12/19/2006 <br />2/2004 ~ 12/4/2006 I $5.09 $0.00 $2.19 $ 7.28 <br />3/2004 12/4/2006 I $249.73 $0.00 $95.91 $ 345.64 <br />- -- <br />4/2004 12/4/2006 $66.31 $25.00 $22.46 $ 113.77 <br /> -. <br /> I $ 0.00 <br /> I <br /> I I $ 0.00 <br /> ~--~. $ 0.00 <br /> $ 0.00 <br /> , . $ 0.00 <br /> $ 0.00 <br /> I $ 0.00 <br /> I ~ <br /> $ 0.00 <br /> - <br /> -$ 0.00 <br />TOTAL Combined Tu or Payment in Lieu ofContribution's Due (under thisliell only): S 466.69 <br /> <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 faUed to pay the amount due after demand. <br />FERNANDO LECU " <br />C <br /> <br />Date: January 31, 2007 <br /> <br />By: <br /> <br /> <br />& <br /> <br />RETURN Fll..ED COPIES TO.: Nebr. Dept. of Labor - LEG~ <br />P.O. DoJ: 94600 <br /> <br />NEBR. DEPT. OF LABOR <br />CHARGE ACCT. #14765 <br />