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•11■tttt= <br />N mmirommomm <br />C <br />v ▪ � <br />OR <br />FINANCING STATEMENT AMENDMENT <br />N INSTRUCTIONS <br />IE & PHONE OF CONTACT AT FILER (optional) <br />1IL CONTACT AT FILER (optional) <br />3 ACKNOWLEDGMENT TO: (Name and Address) <br />.„rnerstone Bank <br />P.0, Box 471 <br />Albion, NE 68620 -0471 <br />1e. INITIAL FINANCING STATEMENT FILE NUMBER <br />201107443 - Hall County <br />2. TERMINATION: Effectiveness of the Financing Statement identified above Is terminated <br />with respect to the security interest(s) of Secured Party authorizing this Termination <br />3. ❑ ASSIGNME (full or partial): Provide name of Assignee in Item 7a or 7b, mg, address of AeeIgnee In Item 7c aLid name of Assignor In Item 9 <br />For partial assignment, complete Items 7 and 9 anti also indicate affected collateral In Item 8 <br />4.0 CONTINUATION: Effeotivenees of the Financing Statement identified above with respect to the amity Interest(s) of Secured Party authorizing this Continuation Statement is <br />continued for the additional period provided by applicable law <br />E. ❑ PARTY INFORMATION CHANGE: <br />Check gm of these two boxes: am Check gm of the three boxes to: <br />y ❑ CHANGE name and/or address: Complete r—,ADD name: Complete item DELETE name: Give rocord name <br />This Change affects <br />❑ Debto gr ❑ Secured Part of record Item Be or eb: gild Item 7a or 7b and Item 70 I_J 7a or 7b, an ❑ Item 7c to be deleted In Item ea or Bb <br />B. CURRENT RECORD INFORMATION: Complete for Party Information Change - provide only =name (ea or eb) <br />ea. ORGANIZATION'S NAME <br />Bb. INDIVIDUAL'S SURNAME <br />Panowioz <br />FIRST PERSONAL NAME <br />Michael <br />ADDITIONAL NAME(S) /INITIAL(S) <br />A <br />7. CHANGED OR ADDED INFORMATION: Complete for Assignment or Party information Change) • provide only gps name (7a or 7b) (use axed, full name: do not 0* modify. or abbreviate any pert of the tkbtm'e name) <br />OR <br />OR <br />Te, ORGANIZATION'S NAME <br />7b. INDIVIDUAL'S SURNAME <br />INDIVIDUAL'S FIRST PERSONAL NAME <br />INDIVIDUAL'S ADDITIONAL NAM E(SMINITIAL(S) <br />7c. MAILING ADDRESS <br />10. OPTIONAL FILER REFERENCE DATA: <br />CITY <br />FILING OFFICE COPY — UGC FINANCING STATEMENT AMENDMENT (Form UCC3) (Rev. 04/20/11) <br />STATE <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />1b.0 Thls FINANCING STATEMENT AMENDMENT is to be filed (for record) <br />(or recorded) In the REAL ESTATE RECORDS <br />Filer ettagli Amendment Addendum (Form UCC3Ad) and provide Debtors name In item 13 <br />POSTAL CODE <br />8. ❑ COLLATERAL. CHANGE: Alm check r» of Iheee four boxes: ® ADD collateral ❑ DELETE collateral ❑ RESTATE covered collateral ❑ ASSIGN collateral <br />Indicate collateral: <br />9. NAME OF SECURED PARTY OF RECORD AUTHORIZING THIS AMENDMENT: Provide only Spa name (9a or 9b) (name of Assignor, If thla is an Assignment) <br />I this Is an Amendment authorized by a DEBTOR, check here ❑ and provide name of authorizing Debtor <br />SUFFIX <br />SU <br />COUNTRY <br />9a. ORGANIZATION '8 NAME <br />Cornerstone Bank <br />9b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />International Association of Commercial Administrators (IACA) <br />rn <br />• rr't <br />ca t , <br />ton <br />C1) <br />Cfl <br />CID <br />- Fri <br />W..! <br />\crS' <br />