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OR <br />la. ORGANIZATION'S NAME <br />JAI KAPISH LLC <br />lb. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S) /INITIAL(S) <br />SUFFIX <br />lc. MAILING ADDRESS <br />2506 PLUM CREEK PKWY <br />CITY <br />LEXINGTON <br />STATE <br />NE <br />POSTAL CODE <br />68850-2814 <br />COUNTRY <br />USA <br />OR <br />2a. ORGANIZATION'S NAME <br />2b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />2c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />OR <br />3a. ORGANIZATION'S NAME <br />Adams Bank & Trust <br />3b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S) /INITIAL(S) <br />SUFFIX <br />3c. MAILING ADDRESS <br />315 North Spruce, P.O. Box 720 <br />CITY <br />Ogallala <br />STATE <br />NE <br />POSTAL CODE <br />69153 -0720 <br />COUNTRY <br />USA <br />C7 <br />C) <br />sie <br />m <br />m INANCING STATEMENT <br />INSTRUCTIONS <br />-r- <br />& PHONE OF CONTACT AT FILER (optional) <br />CONTACT AT FILER (optional) <br />ACKNOWLEDGMENT TO: (Name and Address) <br />JAMS BANK & TRUST <br />CENTRAL LOAN SUPPORT <br />BOX 720 <br />[ OGALLALA, NE 69153 <br />1 <br />n r�. <br />ITI <br />C) <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />1. DEBTOR'S NAME: Provide only mg Debtor name (la 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 Debtors <br />name will not fit in line lb, leave all of item 1 blank, check here D and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad) <br />2. DEBTOR'S NAME: Provide only Qna 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 />3. SECURED PARTY'S NAME (or NAME of ASSIGNEE of ASSIGNOR SECURED PARTY): Provide only one Secured Party name (3a or 3b) <br />4. COLLATERAL: This financing statement covers the following collateral: <br />Purchase Money Security Interest in all Inventory, Chattel Paper, Accounts, Equipment, General Intangibles and Fixtures; whether any of the <br />foregoing is owned now or acquired later; all accessions, additions, replacements, and substitutions relating to any of the foregoing; all <br />records of any kind relating to any of the foregoing. <br />5. Check only if applicable and check only 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 only if applicable and check only one box: 6b. Check only if applicable and check only one box: <br />D i Public- Finance Transaction 0 Manufactured -Home Transaction 0 A Debtor is a Transmitting Utility 0 Agricultural Lien 0 Non -UCC Filing <br />7. ALTERNATIVE DESIGNATION (if applicable): ❑ Lessee/Lessor 0 Consignee /Consignor ❑ Seller/Buyer 0 Bailee/Bailor ® Licensee/Licensor <br />8. OPTIONAL FILER REFERENCE DATA: <br />FILING OFFICE COPY — UCC FINANCING STATEMENT (Form UCC1) (Rev. 04/20/11) <br />D+H <br />400 S.W. 6th Avenue, Portland, Oregon 97204 <br />