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OR <br />1 b. INDIVIDUAL'S SURNAME <br />Panowicz <br />FIRST PERSONAL NAME <br />Robert <br />ADDITIONAL NAME(S) /INITIAL(S) <br />M <br />SUFFIX <br />1c. MAILING ADDRESS <br />4525 N 110th Rd <br />CITY <br />Cairo <br />STATE <br />NE <br />POSTAL CODE <br />68824 -9491 <br />COUNTRY <br />USA <br />OR <br />2b. INDIVIDUAL'S SURNAME <br />Panowicz <br />FIRST PERSONAL NAME <br />Jaime <br />ADDITIONAL NAME(S) /INITIAL(S) <br />L <br />SUFFIX <br />2c. MAILING ADDRESS <br />4525 N 110th Rd <br />CITY <br />Cairo <br />STATE <br />NE <br />POSTAL CODE <br />68824 -9491 <br />COUNTRY <br />USA <br />OR <br />3b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S) /INITIAL(S) <br />SUFFIX <br />3c. MAILING ADDRESS <br />1631 16th Street <br />CITY <br />Central City <br />STATE <br />NE <br />POSTAL CODE <br />68826 -1815 <br />COUNTRY <br />USA <br />N <br />INANCING STATEMENT <br />INSTRUCTIONS <br />E & PHONE OF CONTACT AT FILER (optional) <br />0) <br />IL CONTACT AT FILER (optional) <br />ACKNOWLEDGMENT TO: (Name and Address) <br />)rnerstone Bank <br />P.O. Box 69 <br />529 Lincoln Avenue <br />York, NE 68467 -0069 <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />1. DEBTOR'S NAME: Provide only one Debtor name (1a or 1b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name) if any part of the Individual Debtor's <br />name will not fit in line 1 b, leave all of item 1 blank, check here ❑ and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1 Ad) <br />la. ORGANIZATION'S NAME <br />2. DEBTOR'S NAME: Provide only Me Debtor name (2a or 2b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name); if any part of the Individual Debtor's <br />name will not fit in line 2b, leave all of item 2 blank, check here ❑ and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad) <br />2a. ORGANIZATION'S NAME <br />3. SECURED PARTY'S NAME (or NAME of ASSIGNEE of ASSIGNOR SECURED PARTY): Provide only goo@ Secured Party name (3a or 3b) <br />3a. ORGANIZATION'S NAME <br />CORNERSTONE BANK <br />4. COLLATERAL: This financing statement covers the following collateral: <br />Purchase Money Security Interest in 1991 Model 65 7 Tower Reinke Pivot (SN: 4917458) and Model 220 -DEP well and pump (Catalog <br />#H040S2BLG); whether any of the foregoing is owned now or acquired later; all accessions, additions, replacements, and substitutions <br />relating to any of the foregoing; all records of any kind relating to any of the foregoing. <br />5. Check only if applicable and check ol_Ay one box: Collateral is ❑ held in a Trust (see UCC1Ad, item 17 and Instructions) being administered by a Decedent's Personal Representative <br />6a. Check oily if applicable and check gnly one box: <br />❑ Public- Finance Transaction ❑ Manufactured -Home Transaction ❑ A Debtor is a Transmitting Utility ❑ Agricultural Lien ❑ Non -UCC Filing <br />7. ALTERNATIVE DESIGNATION (if applicable): ❑ Lessee /Lessor ❑ Consignee/Consignor ❑ Seller /Buyer ❑ Bailee /Bailor ❑ Licensee /Licensor <br />8. OPTIONAL FILER REFERENCE DATA: <br />0 4 d <br />I <br />FILING OFFICE COPY — UCC FINANCING STATEMENT (Form UCC1) (Rev. 04/20/11) <br />Cr) <br />6b. Check gnat if applicable and check only one box: <br />Harland Financial Solutions <br />400 S.W. 6th Avenue, Portland, Oregon 97204 <br />