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202105726
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7/6/2021 12:08:09 PM
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7/6/2021 12:08:09 PM
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202105726
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Omimim <br />INANCING STATEMENT <br />INSTRUCTIONS <br />& PHONE OF CONTACT AT FILER (optional) <br />1-800-858-5294 <br />. CONTACT AT FILER (optional) <br />Filing@cscglobal.com <br />4CKNOWLEDGMENT TO: (Name and Address) <br />07983 <br />csc alv <br />R 0 , 13ox 2q (9G' <br />Springfield, IL 62.74 &- toxic, aio p - zq (4, Q Filed In: Nebraska <br />L <br />(Hall) I <br />c- <br />rn <br />r-= CT:) <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />1. DEBTORS NAME: Provide only one 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 fit in line 1 b, leave all of item 1 blank, check here I=1 and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad) <br />OR <br />la. ORGANIZATION'S NAME <br />lb. INDIVIDUALS SURNAME <br />SMITH <br />FIRST PERSONAL NAME <br />SIDNEY <br />ADDITIONAL NAME(S)/INITIAL(S) <br />w <br />SUFFIX <br />lc. MAILING ADDRESS 10007 LOUP RIVER RD W <br />CITY <br />DANNEBROG <br />STATE <br />NE <br />POSTAL CODE <br />68831-2008 <br />COUNTRY <br />USA <br />2. DEBTORS NAME: Provide only ma 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 of the Individual Debtor's <br />name will not fit in line 2b, leave all of item 2 blank, check here I=1 and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad) <br />OR <br />2a. ORGANIZATION'S NAME <br />2b. INDIVIDUALS SURNAME <br />FIRST PERSONAL NAME <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 NAMEService Experts Heating & Air Conditioning LLC <br />3b. INDIVIDUALS SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />3c. MAILING ADDRESS 807 Claude Road <br />CITY <br />Grand Island <br />STATE <br />NE <br />POSTAL CODE <br />68803 <br />COUNTRY <br />USA <br />4. OL T RAS,: Thi financing statement covers the followin toll to{al: <br />The following This <br />property as set forth, In that certain HVAC RENTAL AGREEMENT dated 06/18/2021, by and <br />between Service Experts Heating & Air Conditioning LLC and the Debtor: A ARMSTRONG heating component, Model <br />#BCE5V48MA4X (Serial # 1520M18854) and a ARMSTRONG air conditioner, Model # HSHP15LE142P-50 (Serial # <br />1620J02967), whether now owned or hereafter acquired, together with all replacements thereof, all attachments, <br />accessories, parts <br />and tools belonging thereto or for use in connection therewith; and any and all products and proceeds of any of the <br />foregoing (including, but not limited to, any claims to any items referred to in this definition, and any claims of Debtor <br />against third parties for loss of, damage to or destruction of any or all of the collateral or for proceeds payable under, or <br />unearned premiums with respect to, policies of insurance) in whatever form, including, but not limited to, all cash, <br />interest, principal, royalties, license fees, rents, dividends, negotiable instruments and other instruments for the payment <br />of money, chattel paper, security agreements and other documents or other property from time to time received, <br />receivable or otherwise distributed in respect of, or in exchange for, the collateral. Said collateral is located at address: <br />5. Check only if applicable and check only one box: Collateral is held in a Trust (see UCC1Ad, item 17 and Instructions) being administered by a Decedents Personal Representative <br />6a. Check only if applicable and check only one box: 6b. Check only if applicable and check gl:lty one box: <br />❑ Public -Finance Transaction D Manufactured -Home Transaction D A Debtor is a Transmitting Utility Agricultural Lien Non -UCC Filing <br />7. ALTERNATIVE DESIGNATION (if applicable): ❑ Lessee/Lessor ❑ Consignee/Consignor ❑ Seller/Buyer ❑ Bailee/Bailor El Licensee/Licensor <br />8. OPTIONAL FILER REFERENCE DATA: <br />2135 07983 <br />FILING OFFICE COPY — UCC FINANCING STATEMENT (Form UCC1) (Rev. 04/20/11) <br />
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