201506901 - Laserfiche WebLink

Browse

OR 10a. ORGANIZATION'S NAME 10b. INDIVIDUAL'S SURNAME INDIVIDUAL'S FIRST PERSONAL NAME INDIVIDUAL'S ADDITIONAL NAME(S) /INITIAL(S) SUFFIX 10c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY 11. OR J ADDITIONAL SECURED PARTY'S NAME 1 ❑ ASSIGNOR SECURED PARTY'S NAME: Provide only Qne name (11a or 11b) 11a. ORGANIZATION'S NAME 11b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S)/INITIAL(S) SUFFIX 11c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY UCC FINANCING STATEMENT ADDENDUM FOLLOW INSTRUCTIONS 9a. ORGANIZATION'S NAME JSH FARMS, INC. 9b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S) / INITIAL(S) SUFFIX 9. NAME OF FIRST DEBTOR: Same as line la or 1b on Financing Statement; if line 1b was left blank because Individual Debtor name did not fit, check here OR 10. DEBTOR'S NA Provide (10a or 10b) only one additional Debtor name or Debtor name that did not fit in fine 1b or 2b of the Financing Statement (Form UCC1) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name) and enter the mailing address in line 10c ADDITIONAL SPA FOR ITEM 4 (Collateral): 13. This FINANCING STATEMENT is to be filed (for record] (or recorded) in the REAL ESTATE RECORDS (if applicable) 15. Name and address of a RECORD OWNER of real estate described in item 16 (if Debtor does not have a record interest): JASON E HUMPHREY & SARAH N GREER HUMPHREY 305 SOUTH F ROAD GILTNER, NE 68841 17. MISCELLANEOUS: 14. This FINANCING STATEMENT: p covers timber to be cut ❑ covers as- extracted collateral is filed as a fixture filing 16. Description of real estate: SEE ATTACHED LEGAL DESCRIPTION 201506901 THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY International Association of Commercial Administrators (IACA) FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (Form UCC1Ad) (Rev. 04/20/11)