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201503780
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Last modified
11/5/2015 9:11:28 PM
Creation date
6/8/2015 2:04:32 PM
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DEEDS
Inst Number
201503780
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UCC FINANCING STATEMENT AMENDMENT ADDENDUM <br />FOLLOW INSTRUCTIONS <br />INITIAL FINANCING STATEMENT FILE NUMBER: Same as item la on Amendment form <br />01207930 <br />NAME OF PARTY AUTHORIZING THIS AMENDMENT: Same as item 9 on Amendment form <br />12a. ORGANIZATION'S NAME <br />Five Points Bank <br />12b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />11. <br />2 <br />12. <br />OR <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />13. Name of DEBTOR on related financing statement (Name of a current Debtor of record required for indexing purposes only in some filing offices - see Instruction item 13): Provide only <br />one Debtor name (13a or 13b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtors name); see Instructions 1 name does not fit <br />OR <br />13a. ORGANIZATION'S NAME <br />Bosselman Pump & Pantry, Inc. <br />13b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S)/INITIAL(S) <br />14. ADDITIONAL SPACE FOR ITEM 8 (Collateral): <br />15. This FINANCING STATEMENT AMENDMENT: <br />0 covers timber to be cut [1 covers as- extracted collateral 0I is filed as a fixture filing <br />16. Name and address of a RECORD OWNER of real estate described in item 17 <br />(if Debtor does not have a record interest): <br />18. MISCELLANEOUS: <br />BOSSELMAN PUMP & PANTRY INC Ilia BOSSELMAN INC <br />201503780 <br />SUFFIX <br />17. Description of real estate: <br />LOTS 1, 2, 3, 4, 5 & 6 IN BLOCK 5 IN THE ORIGINAL <br />TOWN OF CAIRO, HALL COUNTY, NEBRASKA <br />International Association of Commercial Administrators (IACA) <br />FILING OFFICE COPY — UCC FINANCING STATEMENT AMENDMENT ADDENDUM (Form UCC3Ad) (Rev. 04/20/11) <br />
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