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201305564 <br /> UCC FINANCING STATEMENT <br /> FOLLOW INSTRUCTIONS(front and back)CAREFULLY <br /> A. NAME&PHONE OF CONTACT AT FILER[optional] <br /> B.SEND ACKNOWLEDGMENT TO: (Name and Address) <br /> _ Equitable Bank <br /> PO Box 160 - <br /> Grand island, NE 68802-0160 <br /> THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br /> 1. DEBTOR'S EXACT FULL LEGAL NAME-insert only one debtor name(la or I b)-do not abbreviate or combine names <br /> l a_ORGANIZATION'S NAME <br /> GRAND ISLAND FIRST DENTAL,P.C. <br /> OR I b_INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX <br /> 1c.MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY <br /> 1566 TRUMBALL TERRACE PLATTSMOUTH NE 68048 USA <br /> Id.SEE INSTRUCTIONS ADD'L INFO RE Ile.TYPE OF ORGANIZATION If.JURISDICTION OF ORGANIZATION lg.ORGANIZATIONAL ID#,if any <br /> ORGANIZATION <br /> DEBTOR Corporation I NE NONE <br /> 2.ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME-insert only one debtor name(2a or 2b)-do not abbreviate or combine names <br /> 2a.ORGANIZATION'S NAME <br /> OR 2b_INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX <br /> SMITH DONALD G <br /> 2c.MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY <br /> 1566 TRUMBALL TERRACE PLATTSMOUTH NE 68048 USA <br /> 2d_SEE INSTRUCTIONS ADD'L INFO RE Ile.TYPE OF ORGANIZATION 2f.JURISDICTION OF ORGANIZATION 2g_ORGANIZATIONAL ID#,if any <br /> ORGANIZATION 1 Individual I <br /> INONE <br /> DE BTOR I , <br /> B-SECURED PARTY'S NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR SIP)-insert only one secured party name(3a or 3b) <br /> 3a.ORGANIZATION'S NAME <br /> Equitable Bank <br /> OR 3b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX <br /> 3c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY <br /> - PO Box 160 Grand Island NE 68802-0160 USA <br /> 4.This FINANCING STATEMENT covers the following collateral: <br /> All inventory,equipment,accounts(including but not limited to all health-care-insurance receivables),chattel paper,instruments(including but <br /> not limited to all promissory notes),letter-of-credit rights,letters of credit,documents,deposit accounts,investment property, money,other <br /> rights to payment and performance,and general intangibles (including but not limited to all software and all payment intangibles);all oil,gas <br /> and other minerals before extraction;all oil,gas,other minerals and accounts constituting as-extracted collateral;all fixtures;all timber to be <br /> cut;all attachments,accessions,accessories,fittings, increases,tools,parts,repairs,supplies,and commingled goods relating to the <br /> foregoing property,and all additions,replacements of and substitutions for all or any part of the foregoing property;all insurance refunds <br /> relating to the foregoing property;all good will relating to the foregoing property;all records and data and embedded software relating to the <br /> foregoing property,and all equipment,inventory and software to utilize,create,maintain and process any such records and data on electronic <br /> media;and all supporting obligations relating to the foregoing property;all whether now existing or hereafter arising,whether now owned or <br /> hereafter acquired or whether now or hereafter subject to any rights in the foregoing property;and all products and proceeds (including but <br /> not limited to all insurance payments)of or relating to the foregoing property. <br /> 5.ALTERNATIVE DESIGNATION[if applicable]: I I LESSEE/LESSOR I I CONSIGNEEICONSIGNOR J 1BAILEBAILOR I (SELLERIBUYER I AG. LIEN I I NON-UCC FILING <br /> This FINANCING STATEMENT is to be filed[for record](or recorded)in the REAL 17_Check to REQUEST SEARCH REPORT(S)on Debtor(s) <br /> ESTATE RECORDS. Attach Addendum �f acolicablel I (ADDITIONAL FEET [optional] L All Debtors u Debtor I LI Debtor 2 <br /> 8.OPTIONAL FILER REFERENCE DATA <br /> FILING OFFICE COPY --UCC FINANCING STATEMENT(FORM UCC1 (REV.05/22/02 Harland Financial Avenue,uSolutions otla <br /> ( �� ) 400 S.V . 6th Avenue,Portland,Oregon 97204 <br />