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<br />02/20/2007 17:30 FAX 14024714429 <br /> <br />NEBRASKA Dee <br /> <br />ra! 0021003 <br /> <br />200701326 <br /> <br />111IIII11I <br /> <br /> <br />990749&446-7 Pes. 1 <br />~H~ TRACV A. <br />Fil.d: 02/20/2007 10:55 ~ <br /> <br />ut. <br /> <br />STATE TAX LIEN .,NEBRAS~DEI"ARTMENTOFLABOR <br />X ORIGINAL <br /> <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 /> <br />Employer Name: Tracy A. Markham /JL Scott Markham d/b/a Merry_Maids <br />._..........___~_~______n._.................._.~________________~-~............---_.._~.........._II;.........-~..............---~~~-~,...........-.--~--~ <br />Address:' 2418 N. Webb Grand Island NE 688.01 . <br /> <br />NDOL Serial No.: LAB-0068-2007 To be fIled with the Register of Deeds in the following Counties: <br /> <br />NDOi-Employer AccLNo.: - 0289743007-- - lian---'---.---'----.--l- ---- <br /> <br />--Federa.IDN~:-ISSANOT47=-0845288-----'~ I--~-"-"'''--'~- -~------ <br /> <br />This State Tax Lien is issued for unpaid combined taxes (Neb. Rev. Stat. ~48.657) or payments in lieu of contributions (Neb. Rev. Stat. ~48-660,O I) pursuant <br />. to .the Unifonn State Tax Lien R.egistration & Enforcement Act (Neb. Rev. Stat. ~77-3901. et seq.), . Notice is given that combined ta.l\es 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 ih lieu of contributions 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 />'1 fu~ <br />Combined Tax Or Payment In Lieu <br />Qtr. / Yr. I Date Assessed Of Contributions Due Penalty Tbrough <br />1/3/2007 <br /> <br />1I200b 12/19/2006 . . $1,59259 - $25.00 . $-194.7~. $1,812.31 <br />.----2/2006 'U719/2006 ----.----.--$.1,332.i9 .-. $0.00.'---$102.46 ~---$1,434.65 <br />---3/200'6- --u.i19/2006"-'" .-.---,-----------". $679.28 "-'-~$-25.00 .------sii.43 "-'---~$725.71- <br />-:--.-'-..---r----..--.-.--...".--l--.-----~-----.:-.---:--~: ----.--- ----- -- ---:$ O.OO~- <br /> <br />=- . :i,--~ F~ -~~ -~ - - - ~~--==:~ - =e~~ <br />~~-~_i--~--~-;.1----.---~-----~-- -------.-.--I-~--_----.~---..- :' ~:~~.- <br /> <br />.-.-----T---.-..-----:--l-----~----..--~--- --..-----~---. -~---$O])O- <br /> <br />= .~ r. ~ ------+---=: ~~ <br />---.-.;-----~-------l----..------~-~~-.- i. 1--.----.-$0':00".. <br />I $3,972.67 <br /> <br />Subtotal <br /> <br />- Tg1;'AL CombIned Tall or Payment in Lieu of Contributions Due (under this lien o,:,ly): <br /> <br />. I cer~fy' 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 d_emand. <br />FERNANDO CUO III <br />C . ion of <br /> <br />Date:. Febroary 20, 2007 <br /> <br />By: <br /> <br /> <br />H , gency Legal Counsel <br />S A. UKINSKI, Legal Counsel <br />S~ELL BARGER, Legal Counsel <br /> <br />RETURN :FILED COPIES TO: Nebr. Dept of Labor - LEGAL <br /> <br />P.O_ Bol( 94600 <br />. ._ u '_ ..".. ':lu:nQ_41>1l1l <br /> <br />NEBR.DEPT.OFLABOR~ <br />CHARGE ACCT. #14765 <br /> <br />..... <br />