Laserfiche WebLink
OR <br />21a. ORGANIZATIONS NAME <br />21b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />21c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />22. <br />OR <br />❑ ADDITIONAL SECURED PARTY'S NAME 4t [] ASSIGNOR SECURED PARTY'S NAME: Provide only ggg name (22a or 22b) <br />22a. ORGANIZATIONS NAME <br />22b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S) / INITIAL(S) <br />SUFFIX <br />22c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />23. <br />OR <br />ll ADDITIONAL SECURED PARTY'S NAME gl • ASSIGNOR SECURED PARTY'S NAME: Provide only one name (23a or 23b) <br />23a. ORGANIZATIONS NAME <br />23b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL. NAME <br />ADDITIONAL NAME(S) / INITIAL(S) <br />SUFFIX <br />23c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />4 <br />UCC FINANCING STATEMENT ADDITIONAL PARTY <br />FOLLOW INSTRUCTIONS <br />NAME OF FIRST DEBTOR: Same as line la or 1b on Financing Statement; if line 1b was left blank <br />because Individual Debtor name did not fit, check here 0 <br />18a. ORGANIZATION'S NAME <br />18b. INDIVIDUAL'S SURNAME <br />PANOWICZ <br />FIRST PERSONAL NAME <br />ROBERT <br />ADDITIONAL NAME(S) / INITIAL(S) <br />M <br />SUFFIX <br />18. <br />OR <br />OR <br />19c <br />4 <br />201404141 <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />19. ADDITIONAL DEBTOR'S NAME: Provide only one Debtor name (19a or 19b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtors name) <br />19a. ORGANIZATION'S NAME <br />19b. INDIVIDUAL'S SURNAME <br />PANOWICZ <br />MAILING ADDRESS <br />25 NORTH 110TH ROAD <br />FIRST PERSONAL NAME <br />ROBERT <br />CITY <br />CAIRO <br />ADDITIONAL NAME(S) / INITIAL(S) <br />MICHAEL <br />STATE <br />NE <br />POSTAL CODE <br />68824 <br />20. ADDITIONAL DEBTOR'S NAME: Provide only gne Debtor name (20a or 20b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtors name) <br />SUFFIX <br />COUNTRY <br />20a. ORGANIZATION'S NAME <br />20b. INDIVIDUAL'S SURNAME <br />PANOWICZ <br />MAILING ADDRESS <br />25 NORTH 110TH ROAD <br />FIRST PERSONAL NAME <br />JAIME <br />CITY <br />CAIRO <br />ADDITIONAL NAME(S) /INITIAL(S) <br />LYNN <br />STATE <br />NE <br />POSTAL CODE <br />68824 <br />OR <br />20c <br />4 <br />21. ADDITIONAL DEBTORS NAME: Provide only gng Debtor name (21a or 2 b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name) <br />SUFFIX <br />COUNTRY <br />24. MISCELLANEOUS: <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDITIONAL PARTY (Form UC CIAP International Association of Commercial Administrators (IACA) <br />1 <br />