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zn� <br />mkIANCING STATEMENT n _ •('•' <br />STRUCTIONS <br />0) PHONE OF CONTACT AT FILER (optional) <br />AN TUREK 308)395-8586 <br />1DVIIIS8V '1'0 <br />CONTACT AT FILER (optional) <br />n.Turek@usda.gov <br />.CKNOWLEDGMENT TO: (Name and Address) <br />HALL COUNTY FARM SERVICE AGENCY <br />703 S WEBB RD., SUITE A <br />GRAND ISLAND, NE 68803 <br />L <br />1 <br />rn <br />_3 <br />LJ <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />1. DEBTORS NAME: Provide only Qng Debtor name (1 a or lb) (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 1b, leave all of item 1 blank, check here ❑ and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad) <br />la. ORGANIZATION'S NAME <br />OR <br />1b. INDIVIDUAL'S SURNAME <br />KURPGEWEIT <br />FIRST PERSONAL NAME <br />CHAD <br />ADDITIONAL NAME(S)/INITIAL(S) <br />A <br />SUFFIX <br />lc. <br />9555 <br />MAILING ADDRESS <br />N CONSTITUTION AVE <br />CITY <br />KENESAW <br />STATE <br />NE <br />POSTAL CODE <br />68956 <br />COUNTRY <br />USA <br />f thl <br />2. DEBTORS NAME: Provide only mg 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 oe Individua <br />name will not fit in line 2b, leave all of item 2 blank, check here 0 and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad) <br />2a. ORGANIZATION'S NAME <br />OR <br />2b. INDIVIDUAL'S SURNAME <br />KURPGEWEIT <br />FIRST PERSONAL NAME <br />JENNIFER <br />ADDITIONAL NAME(S)/INITIAL(S) <br />5 <br />SUFFIX <br />2c. <br />9555 <br />MAILING ADDRESS <br />N CONSTITUTION AVE <br />CITY <br />KENESAW <br />STATE <br />NE <br />POSTAL CODE <br />68956 <br />COUNTRY <br />USA <br />3. SECURED PARTY'S NAME (or NAME of ASSIGNEE of ASSIGNOR SECURED PARTY): Provide only me Secured Party name (3a or <br />3a. ORGANIZATION'S NAME <br />FARM SERVICE AGENCY AGENCY OF THE UNITED STATES OF AMERICA <br />OR <br />3b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />3c. <br />703 <br />MAILING ADDRESS <br />S WEBB RD., SUITE A <br />CITY <br />GRAND ISLAND <br />STATE <br />NE <br />POSTAL CODE <br />68803 <br />COUNTRY <br />USA <br />4. COLLATERAL: This financing statement covers the following collateral: <br />(a) A11 1993 Champion Home Builders Co./FMHA 28 x 40 Manufactured Home; VIN# 05933526759AB <br />(b) All proceeds, products, replacements, substitutions, additions, accessions, and <br />security acquired hereafter. <br />Disposition of such collateral is not hereby authorized. <br />5. Check only if applicable and check only one box: Collateral is ❑ held in a Trust (see UCC1Ad, item 17 and Instructions) 11 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 />0 Public -Finance Transaction El Manufactured -Home Transaction 0 A Debtor is a Transmitting Utility 0 Agricultural Lien 0 Non -UCC Filing <br />7. ALTERNATIVE DESIGNATION (if applicable): Ili Lessee/Lessor [IIConsignee/Consignor 0 Seller/Buyer 0 Bailee/Bailor El Licensee/Licensor <br />8. OPTIONAL FILER REFERENCE DATA: <br />FILING OFFICE COPY — UCC FINANCING STATEMENT (Form UCC1) (Rev. 04/20/11) <br />International Association of Commercial Administrators (IACA) <br />