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;0 <br />rnn <br />n n <br />rn D <br />UCC FINANCING STATEMENT <br />FOLLOW INSTRUCTIONS front back CAREFULLY <br />A. NAME & PHONE OF CONTACT AT FILER [optional] <br />• B. SEND ACKNOWLEDGMENT TO: (Name and Address) <br />• USDA - Hall County Farm Service Agency <br />P 0 Box 5943 <br />Grand Island, NE 68802 <br />L —ij THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />1. DEBTOR'S EXACT FULL LEGAL NAME -insert only one debtor name (1 a or lb) -do not abbreviate or combine names <br />O CIO <br />N co <br />O <br />O <br />F--� EE✓J <br />CID CO <br />=3 <br />Ia. ORGANIZATION'S NAME <br />OR <br />3b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />3c. MAILING ADDRESS <br />OR <br />1b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />Grand Island <br />Hostetler <br />Eric <br />O <br />c> cn <br />1c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />6613 North Burwick Road <br />Cairo <br />NE <br />z <br />ca <br />1d. TAX ID #: SSN OR EIN <br />A Ile. TYPE OF ORGANIZATION <br />1f. JURISDICTION OF ORGANIZATION <br />C <br />Z rn <br />� rn <br />ORGANIZATION <br />DEBTOR <br />rn <br />01 <br />O <br />NONE <br />O <br />O -n <br />co <br />_n 2 <br />o <br />x rn <br />m <br />� <br />ra <br />h <br />h- + <br />6th <br />L —ij THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />1. DEBTOR'S EXACT FULL LEGAL NAME -insert only one debtor name (1 a or lb) -do not abbreviate or combine names <br />O CIO <br />N co <br />O <br />O <br />F--� EE✓J <br />CID CO <br />=3 <br />2. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only one debtor name (2a or 2b) - do not abbreviate or combine names <br />Ia. ORGANIZATION'S NAME <br />OR <br />3b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />3c. MAILING ADDRESS <br />OR <br />1b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />Grand Island <br />Hostetler <br />Eric <br />Monroe <br />1c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />6613 North Burwick Road <br />Cairo <br />NE <br />68824 <br />1d. TAX ID #: SSN OR EIN <br />A Ile. TYPE OF ORGANIZATION <br />1f. JURISDICTION OF ORGANIZATION <br />1g. ORGANIZATIONAL ID #, if any <br />ORGANIZATION <br />DEBTOR <br />NONE <br />2. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only one debtor name (2a or 2b) - do not abbreviate or combine names <br />3. SECURED PARTY'S NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR S /P) -insert only one secured party name (3a or 3b) <br />2a. ORGANIZATION'S NAME <br />OR <br />3b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />3c. MAILING ADDRESS <br />OR <br />2b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />Grand Island <br />Hostetler <br />Kimberly <br />Katherine <br />2c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />6613 North Burwick Road <br />Cairo <br />NE <br />68824 <br />2d. TAX ID #: SSN OR EIN <br />ADD'L INFO RE 2e. TYPE OF ORGANIZATION <br />2f. JURISDICTION OF ORGANIZATION <br />2g. ORGANIZATION ID #, if any <br />ORGANIZATION <br />DEBTOR <br />NONE <br />3. SECURED PARTY'S NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR S /P) -insert only one secured party name (3a or 3b) <br />4. This FINANCING STATEMENT covers the following collateral: <br />Western Landroller Pump - 500 GPM and Electric Motor - 15 HP - SN #M2333T. Disposition of such <br />collateral is not hereby authorized. <br />o. ALTERNATIVE DESIGNATION [if applicable]: Lj LESSEE/LESSOR I 1CONSIGNEE/CONSIGNOR Lj BAILEE/BAILOR SELLER/BUYER LJAG.LIEN NON -UCC FILING <br />6. X This FINANCING STATEMENT is to filed [for record] (or recorded) in the REAL 17. Check to REQUEST SEARCH REPORT(S) on Debtor(s) <br />ESTATE RECORDS. Attach Addendum if aDDlicablel I [ADDITIONAL FEE 1 [optionall U [optional All Debtors Debtor 1 U Debtor 2 <br />8. OPTIONAL FILER REFERENCE DATA <br />FILING OFFICE COPY - NATIONAL UCC FINANCING STATEMENT (FORM UCC1) (REV. 07/29/98) <br />3a. ORGANIZATION'S NAME <br />United States of America Acting Thru Farm Service Agency <br />OR <br />3b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />3c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />P 0 Box 5943 <br />Grand Island <br />NE <br />68802 <br />4. This FINANCING STATEMENT covers the following collateral: <br />Western Landroller Pump - 500 GPM and Electric Motor - 15 HP - SN #M2333T. Disposition of such <br />collateral is not hereby authorized. <br />o. ALTERNATIVE DESIGNATION [if applicable]: Lj LESSEE/LESSOR I 1CONSIGNEE/CONSIGNOR Lj BAILEE/BAILOR SELLER/BUYER LJAG.LIEN NON -UCC FILING <br />6. X This FINANCING STATEMENT is to filed [for record] (or recorded) in the REAL 17. Check to REQUEST SEARCH REPORT(S) on Debtor(s) <br />ESTATE RECORDS. Attach Addendum if aDDlicablel I [ADDITIONAL FEE 1 [optionall U [optional All Debtors Debtor 1 U Debtor 2 <br />8. OPTIONAL FILER REFERENCE DATA <br />FILING OFFICE COPY - NATIONAL UCC FINANCING STATEMENT (FORM UCC1) (REV. 07/29/98) <br />