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201204313
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201204313
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Last modified
5/31/2012 4:06:54 PM
Creation date
5/31/2012 4:06:54 PM
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DEEDS
Inst Number
201204313
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a � <br />UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS (front and back) CAREFULLY <br />9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT <br />9a. ORGANIZATION'S NAME <br />MOSAIC HOUSING CORP. I <br />OR <br />9b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE <br />10. MISCELLANEOUS: <br />• 103-HH004 <br />201204313 <br />� THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />11. ADDITIONAL DEBTOR EXACT FULL LEGAL NAME - insert only one neme (11a or 11b) - do not abbreviate or combine namas <br />11a. ORGANIZATION'S NAME <br />OR 11b. INDIV�DUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX <br />11a MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY <br />17tl. SEE INS7RUCTIONS ADD'L INFO RE I 11e. TYPE OF ORGANIZATION � 11f. JURISDICTION OF ORGANIZATION I11 g. ORGANIZ4TIONAL ID #, If eny <br />ORGANIZATION <br />DEBTOR <br />12. ADDITIONAL SECURED PAR1Y'S � ASSIGNOR S!P'S NAME - insert only y�g name (12e or 12b) <br />12a. ORGANIZATION'S NAME <br />OR 12b. INDIVIDUAL'S LAST NAME FlRST NAME MIDDLE NAME SUFFIX <br />13. This FINANCING STATEMENT covers � timber to be cut or � as-exVacted 16. Additional collateral description: <br />collaterel, or is flled as a� fixture filing. <br />14. Description of real estate: <br />See Attached Real Estate Description <br />15. Name and address af a RECORD OWNER of abov�described reel eatate <br />(rf Debtor does not hava a record interest): <br />17. Check p�y'rf applicable and check O�jy one box. <br />D ebtor is a n Trust or n T ading with respecl to property held in truat or n DecedenYs Estete <br />18. Check o, nly if applicable and check gr�Jy one box. <br />❑ Debtor is a TRANSMIT7ING Ul7LITY <br />I I�led in connection wlth a Manufadured-Home Trensection <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 05/21/09) <br />
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