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<br /> Nebrasira bept.of l.abor ���
<br /> ,:.,��„"�"' P.O.Sox 94ti00 ,-
<br /> SSO Soulh IGth S�N.. ��"' �V�7�i7 .
<br /> •'"`°'' , Lizcoln,NE 68508-2601
<br /> . DAI1 DOLAN, ) CERTIFICATE OF LIFN
<br /> �� Com¢nxssioner of Y.abor, ) FOR DEY.INQUENT Nr: ;,
<br /> ) UNEMPL01lMEN�'INSiJRANCE -
<br /> vs. j CONTRIBUTION TAXES �
<br /> , o,t'
<br /> . . :, ,� RANDALL P. KOSMICKI,�Iba ) ,.
<br /> .•`�!,;.`:�';'' � y'S SPRINKLER SERVICE ) ,;``y
<br /> ..�' ;.�,. �� � ---
<br /> . �,i��;�. 4223 Manchester Road ) �
<br /> ;�'::,;;�;':�::� GrandIslandNE 68803 ) y
<br /> -�-;�:� Employer Account#002489100� ) _--
<br /> . TO WHOM TT�Y COPTCERN: �'
<br /> ,. ,.�.�,, , � -
<br /> '`�'`�`'�`��� �,the undersi�ned attorney for Dan Ylolan,Commissioner af Labor of the State of Nebraolra,dm __
<br />_ ': �;��:i�>;;;:",— _ " '-- °- :
<br /> ,.��. ,�::,.?�, hereby certify that RAndAll P.Kosmicki,doing busine.ss as iaanoy's�prinacier�srv�cC�us,nti�te3
<br /> � � to the Unemployrt�ent Compensation Fa.a�r1 of the State o�Nebraska for unemployment inu�u�ace
<br /> �" contribution taxes due for the s¢cond,th➢rd su�d fourth quartora of 1996,in the sum of$72d�.17,
<br /> - �'���• and aaiterest in the sum of�79.27,with interest at the rat�of one and one-half percent per month aa
<br />-;.!��,;'�;r`,:��;�� � 724.17,calculate�Bhrough Aprll 30,1997. There is a penalry due in the sum o�i'S40.QOe
<br />-- ,.,_.�..,;,r: the sa�o.$ h
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<br /> ��'�'�'� Dan Dolan,in 1���apacitY as tbe Commissioner of Labor of the State of Nebraska,cluim�a lien iu E,�
<br /> � .:;�E'. _
<br />:_ � '�� the sum of$853.44, until paid ul�oa anY and all properiy, real or personal of oaid �sndy P.
<br /> '� ,:. ` <,. -
<br /> :s�;1.�,.�.,, ICosmicki, doing business ss Randy's Sprinkler Service, and specifically claims a lurn ma the
<br /> '�:f>�:;` following described real estate:
<br />___.,t,` �,��
<br /> �����<<'.:�� �
<br />--;-����� Lot 73, Le Heights 4th S�b-division, City of Cnand Island, Hall
<br />__="",j�s�'� County,Nebraska
<br /> ;�i=`apt�:����'
<br /> r Sa:.,.:_:::.
<br /> �"°,`���.�;;�:�-. � 48-657 as amendec�.
<br />-`'�%;{�'�ks��,, subjec�only to�iens of prior rec:ord�i:rssuant to Neb.$eY._81at.§ • -�
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<br /> _.., i;::; � DATED Apxil�,1997.
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