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07/08/2009 taPED 1S: OS FA]t 402 471 4429 UCC SECRETARX OF STATE ~yy Hall ~~ 200905551 f~J00S/OQS N6 Sae of Sia4tl John R gala - U[C 87l 99091301610_5 Fss : 1 Ft~ed T07/0B/2009R02G360PMRNY STATE TAX LIEN • NEBRASKA DEPARTMENT OF LABOR NDOL Office of Legal Counsel P.O. Box 94600 Lincoln, NE 6$509-4600 X ORIGINAL Telephone - (402) 471-9912 EAX - (402) 471-9917 ', Elmployer or ~_~_____~ Liable_Person: MidwesC Manufacturing Company-~~~~ ~ _ Address:WW 1515 E~reet Grand lsland NE 68802 NDOL Serial No.: LAB-0130-2009 ~~~~~ Ta be filed with the Re inter of Deeds in the fatlowin Counties: _ _ _ _N_D_OL Acct. No.: ' 0321290003 ~~ ~ ~ ____ ____ Hall Federal ID No. / SSA No.: 341982626 .~.. This State Tax Lien is issued for unpaid combined taxes (NeB. Rrr. Star. Qd48~i57 and 48-6b4) or payments in lieu of contributions (Neb. Beta Smt. ra48-b60.01) pursuant to the Uniform State Tax Lien Registration & Enforcement Act (Neh. Rer. Smt. X77-3901, et seq.). Notice is given that combined taxes or paytnenls in lieu of contributions, interest (computed at 1.5% per month), and penalties are due from this employer or person and remain unpaid after demand. These combined taxes nr payments in lieu of contributions constitute a lien far any and all personal prope:ty and real property in the county/cotlnties named, belonging to the employer or person, whether now Awned or hereafter acquired. Qtr. / Yr. 1 Date Assessed Combined Tax Or Payment In Lieu Penalty Interest Through Subtotal Of Contributions Due 7/2/09 1/2007 ~ ~ 6/17/2009 __..__._.._...____~.__.~~ ~ 7$.46 __.__.__._. . ~ $O.OQ $30.71 $ 109.17 -~~ ..___.._._ 4/2007 _ --~---6/17/2Q09.`~._Y _ ~_...,......__._._.._.__. ~~ _ ~, ~~.. __~w_~ _._.____.,~, _$71.59 ~ ___.___...._._..__.__ __~ $0.00 __ ._,_,w__________.._,_ __ __.____ $18.28 ~ ~_.__ $ 89.87 ~~ _ ~ 1/2008 ~~ _ .. ~~ 6/17/2009 ~~ .._~ $1,228.41 .. . ~ ~.W~~µ~" $0.00 $259,20 $1,487.61 2/2008 6/17/2009 _.. ... ____._._.~..___ ._ $24.39 ~ $0.00 ~ $4.04 4~~$ 28.43 __._..~._..__._...._._. _...____12009, v~~...v~..._...__-~.__ 6/17/2009 ~ ~~.~ ~. $790.57 .._._..__~.__.___.___._._..._.__.__-_..____. ._.~ __~~~ $0_QQ ~_~ $24,55 ~.~~~ $ 815.12 __~..~._.___._..._____.._,~._._...~__.~__.___.____ $ a.0o _ $ o.oo ____.._.___.._.__..__ ~ ~_____.___._.__._.__.__._~ __~..,.~..____.___..._...._.._._..~.~__w.....__..______~_ ~._ .~ ".~ $ o.oo _~ _____._._......._.___ ~_.____-__~__..._~ __E _ __.~__..___._______.~__.__ $ o.oo ____.~__~._.__._.__.._.__._. _ ~ _.._...___._.______ _ ~.~~..~..._ _ ..._._ $ o.oo TOTAL Ctmbined Tax or Payment in lieu oTCuntrihutians Due (under this lien nnlvL• e~.san.~n 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 or person has failed to pay the amount due after demand. CATHERINE D. LANG Commissioner of Labor Date: July 8, 2009 1By: _._._ HN H. ALB1N, Agency Legal Counsel T:\t>OCtIMENTS\FORMS\Liens\Original.doc THOMAS A. UKINSKI, Legal Counsel RETURN FILED COPIES TO: Nebr. Dept. of Labor -LEGAL P.o. aox 9a6oD Lincoht, NE t-8.509~50D ~? NEBR. DEPT. OF LABOR CHARGE ACCT. #147b5 ... \ ~ ~ ,