Laserfiche WebLink
UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS <br />9. NAME OF FIRST DEBTOR: Same as line la or lb on Financing Statement; if line 1b was left blank <br />because Individual Debtor name did not fit, check here 0 <br />OR <br />9a. ORGANIZATIONS NAME <br />90. INDIVIDUAL'S SURNAME <br />LOSEE <br />FIRST PERSONAL NAME <br />RODNEY <br />A <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />202009742 <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />10. DEBTOR'S NAME: Provide (10a or 10b) only gig additional Debtor name or Debtor name that did not fit in line lb or 2b of the Financing Statement (Forrn UCC1) (use exact, full name; <br />do not omit, modity, or abbreviate any part of the Debtors name) and enter the mailing address in line 10c <br />OR <br />10a. ORGANIZATIONS NAME <br />10b. INDIVIDUAL'S SURNAME <br />INDIVIDUAL'S FIRST PERSONAL NAME <br />INDIVIDUAL'S ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />10c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />11. <br />OR <br />ADDITIONAL SECURED PARTY'S NAME <br />BC <br />In <br />ASSIGNOR SECURED PARTY'S NAME: Provide only gag name (11a or 11b) <br />11a. ORGANIZATIONS NAME <br />11b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S)ANITIAL(S) <br />SUFFIX <br />11c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />12. ADDITIONAL SPACE FOR ITEM 4 (Collateral) <br />13. m This FINANCING STATEMENT is to be filed [for record) (or recorded) in the <br />REAL ESTATE RECORDS (if applicable) <br />14. This FINANCING STATEMENT: <br />❑ covers timber to be cut 0 covers as -extracted collateral m is filed as a fixture filing <br />15. Name and address of a RECORD OWNER of real estate described in item 16 <br />RODNEY A LOSES interest): <br />DEBRA M LOSEE <br />113 E BROOKLYN AVE <br />DONIPHAN NE 68832 <br />16. Description of real estate: <br />Legal Description:DONIPHAN VILLAGE RIEF ADD E 30' LT 7 & W <br />35' LT 8 BLK 1 <br />County:HALL,NE APN:400346974 <br />Census Tract/Block:13.00/2 <br />Altemate APN:3539-00-0-60080-001-0009 <br />Subdivision: DONIPHAN VILLAGE RIEF ADD <br />Legal Lot:7 Legal Block:1 <br />Munic/Township: DON VLG 26 <br />17. MISCELLANEOUS: <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (Form UCC1Ad) (Rev. 04/20/11) <br />