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202401562
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Last modified
4/12/2024 11:32:41 AM
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4/12/2024 11:32:41 AM
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202401562
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UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS <br />9. NAME <br />because <br />OR <br />OF FIRST DEBTOR: Same as line 1a or 1b on Financing Statement; if line 1b was left blank <br />Individual Debtor name did not fit, check here <br />9a. ORGANIZATION'S NAME <br />9b. INDIVIDUAL'S SURNAME <br />ACOSTA <br />FIRST PERSONAL NAME <br />BRENDA <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />10. DEBTOR'S NAME: Provide (10a or 10b) only one additional Debtor name or Debtor name that did not fit in Zine <br />do not omit, modify, or abbreviate any part of the Debtor's name) and enter the mailing address In line 10c <br />202401562 <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />1b or 2b of the Financing Statement (Form UCC1) (use exact, full name; <br />10a. ORGANIZATION'S NAME <br />OR 10b. INDIVIDUAL'S SURNAME <br />INDIVIDUAL'S FIRST PERSONAL NAME <br />INDIVIDUAL'S ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />10c. MAILING ADDRESS <br />CITY <br />Grand Island <br />STATE <br />NE <br />POSTAL CODE <br />68801 <br />COUNTRY <br />11.0 ADDITIONAL SECURED PARTY'S NAME 41 0 ASSIGNOR SECURED PARTY'S NAME: Provide only glag,name (11aor 11b) <br />OR <br />11a. ORGANIZATION'S NAME <br />11b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S)/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 />13. a This FINANCING STATEMENT Is to be filed [for record] (or recorded) in the 14. This FINANCING STATEMENT: <br />REAL ESTATE RECORDS (if applicable) <br />covers timber to be cut covers as -extracted collateral <br />Is filed as a fixture filing <br />15. Name and address of a RECORD OWNER of real estate described in item 16 <br />(if Debtor does not have a record interest): <br />16. Description of real estate: <br />Legal Description: FIFTHSTREET SUB LT 12 <br />County: HALL, NE APN: 400059819 <br />Census Tract / Block: 2.00 / 4 Alternate <br />APN: 3315-00-0-13085-000-0013 <br />Township -Range -Sect: Subdivision: FIFTH STREET <br />SUB <br />Legal Book/Page: Map Reference: / <br />Legal Lot: 12 Tract #: <br />Legal Block: <br />17. MISCELLANEOUS: <br />SECURED PARTY COPY — UCC FINANCING STATEMENT ADDENDUM (Form UCC1Ad) (Rev. 07/01/23) <br />
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