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rn UCC FINANCING STATEMENT z n FOLLOW INSTRUCTIONS (front and back) CAREFULLY �n ;�. ' -� rn CD A. NAME & PHONE OF CONTACT AT FILER [optional] 1 -< Phone:(800) 331 -3282 Fax: (818) 662 -4141 rV T Z B. SEND ACKNOWLEDGEMENT TO: ( me and Address) 510656 11111MIJACCEPt m ); = —Z7 T> �-D IT 9 3 r ,o co CC Direct Services 6459311 ca P.O. Box 29071 Cil cea Glendale, CA 91209 -9071 N EN E L FIXTURE. File with: Hall, NE THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 1. DEBTOR'S EXACT FULL LEGAL NAME - insert only one debtor name (1a or 1 b) - do not abbreviate or combine names 1a. ORGANIZATION'S NAME OR 1b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME WERNER TAMARA 1c. MAILING ADDRESS CITY STATE I POSTAL CODE 518 E. 1ST ST. GRAND ISLAND NE 68801 1d. SEE INSTRUCTIONS DD'L INFO RE 1e. TYPE OF ORGANIZATION If. JURISDICTION OF ORGANIZATION 1g. ORGANIZATIONAL ID #, if any RGANIZATION DEBTOR 2. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only one debtor name (2a or 2b) - do not abbreviate or combine names 2a. ORGANIZATION'S NAME OR 2b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME 2c. MAILING ADDRESS CITY STATE I POSTAL CODE 2d. SEE INSTRUCTIONS DD'L INFO RE 2e. TYPE OF ORGANIZATION 2f. JURISDICTION OF ORGANIZATION 2g. ORGANIZATIONAL ID #, if any ORGANIZATION DEBTOR 3. SECURED PARTY'S NAME (or NAME of TOTAL ASSIGNEE of ASSIGNORS /P) - insert only one secured party name (3a or 3b) 3a. ORGANIZATION'S NAME PRIME ACCEPTANCE CORPORATION m N o � N �I o 0 s � C✓ CD s O SUFFIX COUNTRY NONE SUFFIX COUNTRY RNONE UK 3b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME 3c. MAILING ADDRESS CITY c M COUNTRY 200 W. JACKSON #720 CHICAGO IL 60606 _ rn UCC FINANCING STATEMENT z n FOLLOW INSTRUCTIONS (front and back) CAREFULLY �n ;�. ' -� rn CD A. NAME & PHONE OF CONTACT AT FILER [optional] 1 -< Phone:(800) 331 -3282 Fax: (818) 662 -4141 rV T Z B. SEND ACKNOWLEDGEMENT TO: ( me and Address) 510656 11111MIJACCEPt m ); = —Z7 T> �-D IT 9 3 r ,o co CC Direct Services 6459311 ca P.O. Box 29071 Cil cea Glendale, CA 91209 -9071 N EN E L FIXTURE. File with: Hall, NE THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 1. DEBTOR'S EXACT FULL LEGAL NAME - insert only one debtor name (1a or 1 b) - do not abbreviate or combine names 1a. ORGANIZATION'S NAME OR 1b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME WERNER TAMARA 1c. MAILING ADDRESS CITY STATE I POSTAL CODE 518 E. 1ST ST. GRAND ISLAND NE 68801 1d. SEE INSTRUCTIONS DD'L INFO RE 1e. TYPE OF ORGANIZATION If. JURISDICTION OF ORGANIZATION 1g. ORGANIZATIONAL ID #, if any RGANIZATION DEBTOR 2. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only one debtor name (2a or 2b) - do not abbreviate or combine names 2a. ORGANIZATION'S NAME OR 2b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME 2c. MAILING ADDRESS CITY STATE I POSTAL CODE 2d. SEE INSTRUCTIONS DD'L INFO RE 2e. TYPE OF ORGANIZATION 2f. JURISDICTION OF ORGANIZATION 2g. ORGANIZATIONAL ID #, if any ORGANIZATION DEBTOR 3. SECURED PARTY'S NAME (or NAME of TOTAL ASSIGNEE of ASSIGNORS /P) - insert only one secured party name (3a or 3b) 3a. ORGANIZATION'S NAME PRIME ACCEPTANCE CORPORATION m N o � N �I o 0 s � C✓ CD s O SUFFIX COUNTRY NONE SUFFIX COUNTRY RNONE UK 3b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME 3c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY 200 W. JACKSON #720 CHICAGO IL 60606 4. This FINANCING STATEMENT covers the following collateral: WHOLE HOUSE WATER TREATMENT SYSTEM SUFFIX 5. ALTERNATIVE DESIGNATION [if applicable) X LESSEE/LESSOR CONSIGNEE/CONSIGNOR BAILEE/BAILOR SELLER/BUYER I AG. LIEN NON -UCC FILING 6 rvl This FINANCING STATEMENT is to be filed [for record) (or recorded) in the REAL 7. heck to REQUEST SEAR H REP RT(S) on Debtor(s) ❑ All Debtors L] Debtor 1 ❑ Debtor 2 L ^J ESTATE RECORDS Attach Addendum fif aoolicablel !ADDITIONAL FEEL footionall 8. OPTIONAL FILER REFERENCE DATA 6459311 620030335 Prepared by UCC Direct Services, P.O. Box 29071, FILING OFFICE COPY - NATIONAL UCC FINANCING STATEMENT (FORM UCC1) (REV. 05/22/02) Glendale, CA 91209 -9071 Tel (800) 331 -3282 Z