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202105447
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Last modified
6/28/2021 4:08:33 PM
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6/28/2021 4:08:32 PM
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202105447
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UCC FINANCING STATEMENT ADDITIONAL PARTY <br />FOLLOW INSTRUCTIONS <br />18. <br />OR <br />NAME OF FIRST DEBTOR: Same as line la or lb on Financing Statement; if line lb was left blank <br />because Individual Debtor name did not fit, check here ❑ <br />18a. ORGANIZATION'S NAME <br />18b. INDIVIDUAL'S SURNAME <br />DIXSON <br />FIRST PERSONAL NAME <br />BRIAN <br />J <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />202105447 <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />19. ADDITIONAL DEBTOR'S NAME: Provide only one Debtor name (19a or 19b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name) <br />19a. ORGANIZATION'S NAME <br />OR <br />19b. INDIVIDUAL'S SURNAME <br />DIXSON <br />FIRST PERSONAL NAME <br />AIMEE <br />ADDITIONAL NAME(S)/INITIAL(S) <br />NICOLE <br />SUFFIX <br />19c. MAILING ADDRESS <br />975 6TH AVE <br />CITY <br />ST PAUL <br />STATE <br />NE <br />POSTAL CODE <br />68873 <br />COUNTRY <br />USA <br />20. ADDITIONAL DEBTOR'S NAME: Provide only one Debtor name (20a or 20b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name) <br />20a. ORGANIZATION'S NAME <br />OR <br />20b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />20c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />21. ADDITIONAL DEBTOR'S NAME: Provide only>� ne Debtor name (21a or 21b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name) <br />21a. ORGANIZATION'S NAME <br />OR <br />21b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />21c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />RED PARTY'S NAMEQr ❑ ASSIGNOR SECURED PARTY'S NAME: Provide only one name (22a or 22b) <br />-- <br />OR <br />— - - - _ _ <br />22a. ORGANIZATION'S NAME <br />22b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />22c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />'S NAME or ❑ ASSIGNOR SECURED PARTY'S NAME: Provide onlygne name (23a or 23b) <br />OR <br />23a. ORGANIZATION'S NAME <br />23b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />23c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />24. MISCELLANEOUS: <br />International Association of Commercial Administrators (IACA) <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDITIONAL PARTY (Form UCC1AP) (Rev. 08/22/11) <br />
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