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202102714
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Last modified
4/5/2021 9:55:05 AM
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4/5/2021 9:55:05 AM
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202102714
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FINANCING STATEMENT <br />dV INSTRUCTIONS <br />AE & PHONE OF CONTACT AT FILER (optional) <br />>C 1-800-858-5294 <br />AIL CONTACT AT FILER (optional) <br />'RFiling@cscglobal.com <br />VD ACKNOWLEDGMENT TO: (Name and Address) <br />)85 61856 OA) <br />CSC <br />A,dlai-Steve' ci e Q <br />Springfield, IL 62706-- 2 q -4/ <br />L <br />Filed In: Nebraska <br />(Hall) I <br />nn <br />=1> <br />rri <br />nI <br />Cr) <br />(r <br />CO <br />Cr <br />CO <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />1. DEBTOR'S NAME: Provide only gpg Debtor name (la 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 ft in line lb, 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 />OR <br />la. ORGANIZATION'S NAME <br />1b. INDIVIDUAL'S SURNAME <br />HARTMANN <br />FIRST PERSONAL NAME <br />NATHAN <br />ADDITIONAL NAME(S)/INITIAL(S) <br />E <br />SUFFIX <br />lc. MAILING ADDRESS 11769 W HUSKER HWY <br />CITY <br />WOOD RIVER <br />STATE <br />NE <br />POSTAL CODE <br />68883 <br />COUNTRY <br />USA <br />2. DEBTOR'S NAME: Provide only oat Debtor name (2a or 2b) (use exact, full name; do not omit, modify, or abbreviate any cart 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 />2a. ORGANIZATION'S NAME <br />v" <br />2b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />3b. INDIVIDUAL'S SURNAME <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />2c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />3. SECURED PARTY'S NAME (or NAME of ASSIGNEE of ASSIGNOR SECURED PARTY): Provide only one Secured Party name (3a or 3b) <br />OR <br />3a. ORGANIZATION'S NAME DIVERSIFIED FINANCIAL SERVICES, LLC <br />3b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />3c. MAILING ADDRESS 14010 FNB PARKWAY STE 400 <br />CITY <br />OMAHA <br />STATE <br />NE <br />POSTAL CODE <br />68154 <br />COUNTRY <br />USA <br />4.1CQ► LA L2AL 0021T ODELanonns9500CCe MMIbQ ATFC°ll tereL <br />-TOWER WITH CORNER 1542' <br />5. Check only if applicable and check D y 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 play if applicable and check only one box: 6b. Check gay if applicable and check pp(y one box: <br />ElPublic -Finance Transaction 0 Manufactured -Home Transaction 0 A Debtor is a Transmitting Utility Agricultural Lien D Non -UCC Filing <br />7. ALTERNATIVE DESIGNATION (if applicable): El Lessee/Lessor fl Consignee/Consignor 0 Seller/Buyer El Bailee/Bailor 0 Licensee/Licensor <br />8. OPTIONAL FILER REFERENCE DATA: :209103-002 <br />2085 61856 <br />FILING OFFICE COPY — UCC FINANCING STATEMENT (Form UCC1) (Rev. 04/20/11) <br />
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