Laserfiche WebLink
VK <br />11b. INDIVIDUAL'S LAST NAME <br />Sullivan <br />FIRST NAME <br />Timothy <br />MIDDLE NAME <br />SUFFIX <br />11c. MAILING ADDRESS <br />7711 W Walin Ln <br />CITY <br />Lincoln <br />STATE <br />NE <br />POSTAL CODE <br />68532 - 9200 <br />COUNTRY <br />USA <br />11 d. <br />SEE INSTRUCTIONS <br />ADD'L INFO RE 1 e. TYPE OF ORGANIZATION <br />ORGANIZATION I Ind <br />DEBTOR <br />11f. JURISDICTION OF ORGANIZATION <br />11g. ORGANIZATIONAL ID #, if any <br />NONE <br />12. <br />OR <br />— 1 ADDITIONAL SECURED PARTY'S or n ASSIGNOR S /P'S NAME - insert only one name (12a or 12b) <br />12a. ORGANIZATIONS NAME <br />12b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />12c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />13. This FINANCING STATEMENT covers , timber to be cut or , as- extracted <br />collateral, or is filed as a , fixture filing. <br />14. Description of real estate: <br />Exhibit "A" <br />15. Name and address of a RECORD OWNER of above - described real estate (d <br />Debtor does not have a record interest): <br />16. Additional collateral description: <br />17. Check only if applicable and check oral/ one box. <br />Debtor is a n Trust or n Trustee acting with respect to property held in trust or n Decedents Estate <br />18. <br />I <br />I Filed <br />I Filed <br />Check Ely if applicable and check only one box. <br />Debtor is a TRANSMITTING UTILITY <br />in connection with a Manufactured -Home Transaction <br />in connection with a Public-Finance Transaction <br />NAME OF FIRST DEBTOR (la or 1b) ON RELATED FINANCING STATEMENT <br />9a. ORGANIZATIONS NAME <br />9b. INDIVIDUAL'S LAST NAME <br />Sullivan <br />MISCELLANEOUS: <br />FIRST NAME <br />Timothy <br />MIDDLE NAME, SUFFIX <br />J <br />UCC FINANCING STATEMENTADDENDUM <br />FOLLOW INSTRUCTIONS (front and back) CAREFULLY <br />9. <br />OR <br />10. <br />11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only one name (11a or 11b) - do not abbreviate or combine names <br />11a. ORGANIZATIONS NAME <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 05/21/09) <br />201301951 <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />Harland Financial Solutions <br />400 S.W. 6th Avenue, Portland, Oregon 97204 <br />