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202200832
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Last modified
2/1/2022 11:35:55 AM
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2/1/2022 11:35:55 AM
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202200832
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• <br />• <br />UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS <br />9. <br />OR <br />AME OF FIRST DEBTOR: Same as line 1a or 1b on Financing Statement; if line 1b was left blank <br />ecause Individual Debtor name did not fit, check here <br />9a. ORGANIZATIONS NAME <br />9b. INDIVIDUALS SURNAME <br />ANDERSON <br />FIRST PERSONAL NAME <br />DENNIS <br />J. <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />2022006,2_, <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />10. DEBTORS NAME: Provide (10a or 10b) only gig additional Debtor name or Debtor name that did not fit in line 1b or 2b of the Financing Statement (Form UCC1) (use exact, full name; <br />do not omit, modify, or abbreviate any part of the Debtor's name) and enter the mailing address in line 10c <br />10a. ORGANIZATIONS NAME <br />UK <br />10b. INDIVIDUAL'S SURNAME <br />INDIVIDUALS FIRST PERSONAL NAME <br />INDIVIDUALS ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />10c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />11. <br />OR <br />II ADDITIONAL SECURED PARTY'S NAME gt II ASSIGNOR SECURED PARTY'S NAME: Provide only mg name (11a or 11b) <br />11a. ORGANIZATIONS NAME <br />11 b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAMES)/INITIAL(S) <br />SUFFIX <br />11c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />12. ADDITIONAL SPACE FOR ITEM 4 (Collateral): <br />3004 BRENTWOOD WAY <br />GRAND ISLAND , NE 68801 <br />THIS FILING IS MADE FOR NOTICE PURPOSES ONLY. THE DEBTOR HAS NO OWNERSHIP RIGHTS IN THE <br />COLLATERAL. THE DEBTOR IS LEASING THE COLLATERAL. <br />13. m This FINANCING STATEMENT is to be filed [for record] (or recorded) in the <br />REAL ESTATE RECORDS (if applicable) <br />14. This FINANCING STATEMENT: <br />covers timber to be cut ❑ covers as -extracted collateral 71 is filed as a fixture filing <br />15. Name and address of a RECORD OWNER of real estate described in item 16 <br />f Debtor does not have a record interest): <br />DENNIS J. ANDERSON <br />3004 BRENTWOOD WAY <br />GRAND ISLAND , NE 68801 <br />16. Description of real estate: <br />ALL THAT LOT, PIECE OR PARCEL OF LAND, SITUATE IN THE <br />CITY OF GRAND ISLAND, COUNTY OF HALL, STATE OF <br />NEBRASKA, BEING KNOWN AND DESIGNATED AS LOT 18, <br />BLOCK 2, BRENTWOOD SECOND SUBDIVISION. <br />PARCEL ID# 400025744 <br />17. MISCELLANEOUS: <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (Form UCC1Ad) (Rev. 04/20/11) <br />
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