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202109971
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Last modified
11/23/2021 11:01:49 AM
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11/23/2021 11:01:48 AM
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202109971
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,INANCING STATEMENT <br />Coln„,an INSTRUCTIONS <br />& PHONE OF CONTACT AT FILER (optional) <br />1-800-858-5294 <br />L CONTACT AT FILER (optional) <br />tFiling@cscglobal.com <br />ACKNOWLEDGMENT TO' (Name and Address) <br />9 71804 2�i <br />CSC (.5DX c7 <br />$IILAdIai Stevenson.W_rn . <br />Springfield, IL 627Q8-Z`� tod1 <br />L <br />Filed In: Nebraska <br />(Hal <br />TN) <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />1. DEBTORS NAME: Provide only one Debtor name (la or 1b) (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 lb, leave all of item 1 blank, check here El 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 />ALLAN <br />FIRST PERSONAL NAME <br />ROBERT <br />ADDITIONAL NAME(S)/INITIAL(S) <br />J <br />SUFFIX <br />JR <br />lc. MAILING ADDRESS 962 S HWY 11 <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 gag 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 ❑ and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad) <br />2a. ORGANIZATION'S NAME <br />OK <br />2b. INDIVIDUAL'S 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 gait Secured Party name (3a or 3b) <br />3a. ORGANIZATION'S NAME DIVERSIFIED FINANCIAL SERVICES, LLC <br />OK <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 />41cW2021TM8?3gEli55 all'g fsiVa?VrOWER 1283' <br />—4 <br />rn <br />rn <br />tzn <br />PCJC <br />rri <br />5. Check mix if applicable and check only one box: Collateral is 0 held in a Trust (see UCC1Ad, item 17 and Instructions) q being administered by a Decedent's Personal Representative <br />6a. Check only if applicable and check galy one box: 6b. Check only if applicable and check Lay one box: <br />❑ Public -Finance Transaction 0 Manufactured -Home Transaction ❑ A Debtor is a Transmitting Utility ❑ Agricultural Lien 0 Non -UCC Filing <br />7. ALTERNATIVE DESIGNATION (if applicable): El Lessee/Lessor ❑ Consignee/Consignor D Seller/Buyer ❑ Bailee/Bailor ❑ Licensee/Licensor <br />8. OPTIONAL FILER REFERENCE DATA: ::0017164-001 stoltenberg 2219 71804 <br />FILING OFFICE COPY — UCC FINANCING STATEMENT (Form UCC1) (Rev. 04/20/11) <br />
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