Laserfiche WebLink
�� <br />�� <br />N � IANCING STATEMENT <br />e � <br />-� �� STRUCTIONS (front and back) CAREFULLY <br />N- �HONE OF CONTACT AT FILER [optional] <br />0 J. SCHWERT (612) 607-7308 <br />c �� <br />� - (NOWLEDGMENT TO: (Name and Address) <br />s �. Schwert, Esquire <br />� �eimer Wolff & Donnelly LLP <br />� ell Mithun Tower — Suite 2000 <br />th Ninth Street <br />� Minneapolis, MN 55402-3338 <br />� <br />e�+� � � <br />C <br />� ■ • � <br />��.. <br />�n <br />� <br />� <br />_� <br />r r <br />r �'� ^ <br />c-� r '',,_ _ <br />0 <br />� , ._. <br />r , r . _ . <br />o /`-� <br />� <br />� <br />�, <br />� (_',.. <br />� �, <br />°1 4 <br />i-m i r <br />,; i <br />r.n � � <br />r -_ <br />C� <br />r-� <br />-v <br />�- %a <br />r p : <br />_ <br />� <br />� <br />i7 <br />-� <br />cr� <br />�-,; <br />c� <br />n � <br />O � <br />c � <br />z rn <br />� <br />"� o <br />O � <br />-•, z <br />�' r Tl <br />D �-� <br />r :�°� <br />r v <br />c,-, <br />� <br />",�: <br />� <br />�n <br />I THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />1. DEBTOR EXACT FULL LEGAL NAME - insert only one debtor name (1a or 1 b) - do not abbreviate or combirre names OI a. �� G{�d <br />1a. ORGANI7ATION'S NAME <br />oR CHT GRAND ISLAND NE SENIOR LIVING, LLC <br />1b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX <br />1c. MAILING ADDRESS CITY STATE POSTAL CODE <br />450 SOUTH ORANGE AVENUE, SUITE 1200 ORLANDO FL 32801 <br />� _. <br />v 1d. TAX ID#: SSN OR EIN ADD'L IIVFO RE 1a TPEOFORG4I�IDA'i1aV 1f. JURISDICTION OF ORGANIL4TION 1g. ORGANIZ <br />� D B OR r�oN L�,. �;en�uri co. DELAWARE 5092167 <br />�� 2. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only one debtor name (2a or 2b) - do not abbreviate or combirre names <br />2a. ORGANIZATION'S NAME <br />OR <br />2b. INDIVIDUAL'S LAST MAME FIRST NAME MIDDLE NAMI <br />2c. MAILING ADDRESS CI7Y STATE Pf <br />ORGANI7ATION <br />DEBTOR <br />3. SECURED PARTY'S NAME (or NAME of <br />3a. ORGANIZATION'S NAME <br />oR FANNIE MAE <br />3b. INDIVIDUAL'S LAST NAME <br />11501 OUTLOOK STREET, SUITE 300 <br />4. This FINANCING STATEMENT covers the followirm collffieral: <br />2g. <br />�R S!P) - inseK only one secured party name (3a or 3b) <br />FIRST NAME MIDDLE NAME <br />CITY STATE POSTALI <br />OVERLAND PARK KS 66211 <br />ii any <br />� <br />N � <br />F-� � <br />F_a <br />� � <br />L � � <br />c.n � <br />�v <br />s <br />a 3.�; <br />USA <br />� NONE <br />� NONE <br />[il.y] <br />SEE SCHEDULE "A" ATTACHED HERETO AND INCORPORATED HEREIN BY REFERENCE. <br />5. ALTERNATIVE DESIGNATION [if applicablej: u LESSEFJLESSOR u CONSIGNEE/CONSIGNOR u BNLEE/BAILOR u SELLER/BUYER <br />6. This FINANCING STATEMENT is to be filed [for recordj (or recorded) in the REAL 7. Check to REQUEST SEARCH REPORT(S) on Dabtor(s) <br />� ESTATE RECORDS. Attach Addendum ['rf appliceble� I [ADDITIONAL FEE] [optionelj <br />AG. LIEN I I NON-UCC FILING <br />All Debtors I I Debtor 1 I I Debtor 2 <br />OWD FILE NO. 23466/211 <br />FILING OFFICE COPY — NATIONAL UCC FINANCING STATEMENT (FORM UCC7) (REV. 07/29/98) <br />