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<br />03/06/2009 FRI 14:49 FAX 402 471 4429 UCC SECRETARY OF STATE 444 Hall <br /> <br />~004/004 <br /> <br />rfJ <br /> <br /> <br />9909589152-6 Pgs: 1 <br />SNYDER RYAN <br />Fi!ed; 03/06/2009 02:29 PM <br /> <br />200901697 <br /> <br />STATE TAX LIEN. NEBRASKA DEPARTMENT OFLABOR <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 />X ORIGINAL <br /> <br />Employer or <br />~~_______1jable Pe':!!>_l!~_I3Y-~!!_~>.:d~!.zRcyb/a T~eatin~_ Aif._.____._..._..._..___..___._._._____.___...._..._........._.._....._.._.....__...._.___._____..___________..__ <br />Address: 304 S. Plum, Grand Island, NE 68801 <br />NDOL S~i~!~o.: l. LAB-0041-2009 '__________ __!.~._~~!!~.~yit~the R~.!!!!!..~..!.!leedl!.!.!-~he follo..~!!~.~_~!!~!!~___. <br />NDOL Acct. No.: I 0328863001 Hall : . ! <br />~~_~~_~~....~.y~.~._.~_._.~_~_...__M__~..______~__~~~ _~~ L-~_.~ ~~.___........M...~.~__~~~.__._ <br />Federal ID No.1 SSA No.: ! 50-5960079 <br /> <br />This Slate Tax Lien is issued for unpaid combined taxes (Neb. Rev. SiaL ~~48-657 and 48-664 )or payments in lieu of contributions (Neb. Rev. Stat. ~48-660.0 I) pursuant to the <br />Uilifonn Slate Tax Lien Registration & Enforcement Act (Neb. Rev. StaL ~77-3901, et seq.). Notice is given 1hllt combined taxes or payments in lieu of contributions, interest <br />(computed at 1.5% per month), and penalties are due from this employer or person and remain unpaid after demand. These combined taxes or payments in lieu of conlributio~s <br />constitute a lien for any and all personal property and real property in the county/counties named, belonging to the employer or person, whether now owned or hereafter acquired. <br /> <br />Interest : <br />Qtr.1 Yr. Date Assessed Combined Tax Or Payment In Lieu Penalty Through: Subtotal <br />I I Of Contributions Due I I 2/21/2009 I <br /> <br />1/2007 I 2/6/2009 I $395.55 i $0.00 i $129.29 i $ 524.84 <br />"-~-~--~..~~...~-~-.....~--................!~-~.~-u.-~..~~~~.~~.~-t"---~-~~._.~~.....~~_~_~_.___~__.._..._,..__~._.~_._u_....__.M_:-y'~---~-~~~---~~.......+---...............~.~~-....~.-.~-.~~~----r~ <br />..n_.._.--~~_.,.......~.~_".__..,~_,_~.~ <br />2/2007 i 2/612009 I $395.55 i $0.00 i $111.35 i $ 506.90 <br />------.--.--..--..-.-...---..-..+----.-.-...-.-.-.....-.-...-.-~-;...-.-....-...---...~----.---.----......-...-..---..--.--....--...----..-...-...---.----.---....--..---t-------------..-------------. <br />..!-......--....----------------------------.-......----,,- <br />_____....~~?..~2_..____l~____..~!~~?~.~_...._.._._L-.--....._..__._______._..._____~___...___~~.~~~_~--.---.---$O.OO_~----.---.~~~:~-l---i~..-.-...-...-....~-~-~.:~.?.... <br />412007 ! 2/6/2009 I $395.55 ! $0.00 i $75.47 ! $ 471.02 <br />_____..m._._.._..._,,___~_'_..~..____________._____.__.......__.........-.."-...-....-...--....----..-.-.-..-.-...-.--,,.-...-,,'-.---".--...-.".--.......-..J...-.--.....-.-.-....-......--.--r-.--... <br />.-.......---...--..-......-.'-..,..~.----------.........-...-...-...--~..-..-.... <br />Ii! i . I $ 0.00 <br />................~~-~--~~-~~--""""'"i"'-~_.~-~.-..._...,.__.~-,-,..~~~-"'..~~~-'_._'~'--_.~----------~...........,~--.~~--'~~-~'~r.~~'~~~~~~~~~l-_~._~-m~_."~~.~".._._~;~~---~.-~."._gy..y'-~'--.-.~..-- <br />,. <br />'I ; - t I $ 000 <br />i . . ..1..._.. iI, f . <br />----~--..-----.---T.-.....-.-...--.... ....---..- .....'..-..! ... .............-'..-'----.---...-----..~--..-....-----------.......-..-..-.....---.-.-.-......-....T~-----------------'--------r------ <br />--...-------..----.-........-.t--.---------...-....-...-------- <br />i! i' I $ 0.00 <br />~._...---....~----.-~'-.--.--~----...'-...------..----i---~--.------"----....---.-.-..----..---'--'-----.--~...-..--~.--.~.....--1----..~------.-.-------...-...-.1----........-'...---..---.--..-'--.. <br />-.....--..---..----....---...------. <br /> <br />---------..----'~-------~-.--......--.....-----.-.-..-------i~----------------------...-..-------.,,-.-----..,,-.-.-....-.---.---i---.-.----...-....---..-+.-----.--~..-----l-----..-....-.._.____~_._g <br />_~9=: <br /> <br />--.--...-...----.--...--..-.---+....----------------...-....-.-........--.--+---...-..--..----.-..--..-....-...-'---------------.-.---..--------...-------L-~-----...----"...---.-.i.----.....---.....- <br />-...----~--!-.-...---...-...-......-.-~-.-~:..o.~.....- <br />: i l: j $ 0.00 <br />_~._~r~.__~~__._~~.~~".""~,i.--~.___~~._~___~___,__,~,_.~-i'-'-"..~.._.-.~--..~-~~~._-~~..~~........................--.~--~~'-.--.~-~-~- ~~.~..........~...............~_..........._.,j....~~".~~~..~~ <br />~~"_.r.____.__.__ .-~-----.,_._...__~.__~"_._r <br />!! i I I -- $ 0.00 <br />..--.-~..------.-.-.--------i'"~-----------..-.-----I.--.--.-...-.--.--.-.----.-..~---.-.-_.-.-_.---~.-.-.--...----~..i--.-...-.---.-----.-----:----.-.--..-.---..--.-.--.---.1--..--'---...-......-... <br />-..-.------.....-. <br />i! i i I $ 0.00 <br />TOTAL Combined Tax or Payment in Lieu ofCootributions Due (under this lien only): ! $1,991.72 <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 or person has failed to pay the amount due after demand. <br />CATHERINE D. LANG <br />er of bor <br /> <br />Date: March 6, 2009 <br /> <br />By: <br /> <br /> <br />gency Legal Counsel <br />S A. UKINSKI, Legal Counsel <br /> <br />T;\OOCUMENTS\Liens\State Tax Liens\03 20000 000'03 28863 OOI.do: <br /> <br />RETURN FILED COPIES TO: Nebr. Dept. of Labor ~ LEGAL <br /> <br />P.O. Box 94600 <br />Lincoln, NE 68509-4600 <br /> <br />NEBR. DEPT. OF LABOR <br />CHARGE ACCT. #147~p <br />