201702552 - Laserfiche WebLink

Browse

OR lob. INDIVIDUAL'S SURNAME INDIVIDUAL'S FIRST PERSONAL NAME INDIVIDUAL" DD T • A SAME(') N TIA (') X 10c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY 11. OR ■ ADDITIONAL SECURED PARTY'S NAME of ASSIGNOR SECURED PARTY'S NAME: Provide only inn name (Ile or lib) 110. ORGANIZATION'S NAME 118. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S)HNITIAL(S) SUFFIX 11c.. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY UCC FINANCING STATEMENT ADDENDUM FOLLOW INSTRUCTIONS AME OF FIRST DEBTOR; Same as line to or tb on Financing Statement If line lb was left blank eceuae individual Debtor name did not 01, check here El Be. ORGANIZATION'S NAME Bb. INDIVIDUAL'S SURNAME Panowicz FIRST PERSONAL NAME Robert M ADDITIONAL NAME(S)/INITIAL(S) SUFFIX S. OR 10a. ORGANIZATION'S NAME 201702552 THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 10. DEBTOR'S NAME: Provide (10a or 101s) only gag additional Debtor name or Debtor name That did riot fit In fine 1b or 2b of the Financing Statement (Form UCCI) (use exec, full name; '"'' do not omit, modify, pr abbreviate any part of the Debtors name) and enter the making address In One 10c 12. ADDITIONAL SPACE FOR ITEM 4 (Collateral) 13. Q Thla FINANCING STATEMENT la 10 be God (for r000rd) (or recorded) In the REAL ESTATE RECORDS (If oppllcab1o) 15. Name end eddresa of a RECORO OWNER of reat estate described In Item 10 (11 Debtor does nol have a record Interest): Robert Panowicz 17. MISCELLANEOUS: 14. Thla FINANCING STATEMENT: E] cover. timber to be mil ❑ covers ea•exlraced collateral 0 Is filed as a fixture hkng 10. Description of real estate: See Exhibit A International Association of Commercial Administrators (IACA) FILING OFFICE COPY— UCC FINANCING STATEMENT ADDENDUM (Form UCC1Ad) (Rev. 04120111)