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~- ~ z ~I ~()FTt~ R. HANLON, Coii~ssioner of Labor vs. _ Robert Puhalla, d/b/a __ SUPER SUB SHOP _ Employe-r Account ~iU0917Q30d9 TD Wf30M IT MAY CQNCERN: Certificate of Lien for Delinquent Unemployment Insurance Contributions 81-- u~-4294 The undersigned, Paul D. Kratz, attorney ror John R. Hanlon, Commissioner of Lobar of the State of Nebraska, does hereby certify these Robert Puhalla, doing business as Super Sub Shcp, a sole proprietorship, doing business in Grand Island, Hall County, Nebraska, is indebted to the Unemployment Compensation Fund of the State of Nebraska for contributions due on its employment for the second, third and fourth quarters of 1980, in the sum of 5125.01, and interest in the sum of $11..77, with interest at the rate of one percent per month on the sum of 5125.01, from August ~5, 1981. By reason thereof, said John R. Hanlon, Commissioner of Labor, on behalf of the Unemployment Compensation Fund, hereby claims a lien in the sum of 5136.78, with interest at the rate of one per Dent per rxx~nth on the sum of 5125.01, until paid, upon any and all property, real or personal, of said Robert Puhalla, doing business as Super Sub Shop, subject only to liens of prior record pursuant to Section 48-657, R.R.S. Ne 43. mow. 1 PAUL D. KRAT At ney or John x. C~anlon, ommissioner of Labor A~f~ufg~Fugpstl^120, 119DE8~1+VI. - STATE V~ i~~a$RASKA i ~ SS. LANCASTER COUNTY ) PAUL D, KRATZ, being first duly sworn upon his oath, de{~ses and says that he is attt.~r_sey for John ~z. Hanlon, Commissioner of `- Labor of the- St-ate. of Nebra3lra; that he is authorl.zed to ;trak~ the above certificate; that the facts set out above are true and correct as he verily believes. ` ,-J , ~4 PA RRATZ '^'~"-~ SUHSCRIBED in my presence and sworn to before me this 20th day of August, 1981. Notary Publlc SEAL: ~~ i