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4/1/2024 4:04:31 PM
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4/1/2024 4:04:31 PM
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202401356
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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 1b on Financing Statement; if line Ib was left blank <br />because Individual Debtor name did not fit, check here ■ <br />18a. ORGANIZATIONS NAME <br />FIRST PERSONAL NAME <br />DONNA <br />18b. INDIVIDUALS SURNAME <br />HARRENSTEIN <br />FIRST PERSONAL NAME <br />LARRY <br />ADDITIONAL NAME(S)/INITIAL(S) <br />M <br />SUFFIX <br />202401356 <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />19. ADDITIONAL DEBTOR'S NAME: Provide only gm Debtor name (19a or 19b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name) <br />OR <br />19a. ORGANIZATIONS NAME <br />19b. INDIVIDUAL'S SURNAME <br />HARRENSTEIN <br />FIRST PERSONAL NAME <br />DONNA <br />ADDITIONAL. NAME(S)/INITIAL(S) <br />JOLENE <br />SUFFIX <br />19c. MAILING ADDRESS <br />13340 S LOCUST ST <br />CITY <br />DONIPHAN <br />STATE <br />NE <br />POSTAL CODE <br />68832 <br />COUNTRY <br />USA <br />20. ADDITIONAL DEBTOR'S NAME: Provide only gig Debtor name (20a or 20b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name) <br />OR <br />20a. ORGANIZATION'S NAME <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 one Debtor name (21a or 2 b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name) <br />OR <br />21a. ORGANIZATIONS NAME <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 />22.. <br />OR <br />ADDITIONAL SECURED PARTY'S NAME gg <br />• <br />ASSIGNOR SECURED PARTY'S NAME: Provide only gag name (22a or 22b) <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 />23.. <br />OR <br />ADDITIONAL SECURED PARTY'S NAME gr <br />• <br />ASSIGNOR SECURED PARTY'S NAME: Provide only ggg name (23a or 23b) <br />23a. ORGANIZATIONS NAME <br />23b. INDIVIDUALS 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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