200306690 - Laserfiche WebLink

Browse

1 1 i•- UCC FINANCING STATEMENTADDENDUM FOLLOW INSTRUCTIONS (front and back) CAREFULLY 9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT 9a. ORGANIZATION'S NAME OR 9b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE PANOWICZ ROBERT M 10. MISCELLANEOUS: 200306690 THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only gng name (11a or 11b) - do not abbreviate or combine names 11a. ORGANIZATION'S NAME U" 11b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 11 c. MAILING ADDRESS CITY STATE P COUNTRY 11d, TAX ID #: SSN OR EIN ADD'L INFO RE 11e. TYPE OF ORGANIZATION I If. JURISDICTION OF ORGANIZATION 11g. ORGANIZATIONAL ID 1i. if any ORGANIZATION DEBTOR NONE 12. ADDITIONAL SECURED PARTY'S Q ASSIGNOR S /P'S NAME - insert only one name (12a or 12b) 12a. ORGANIZATION'S NAME OR 12b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 12c. MAILING ADDRESS CITY STATE P COUNTRY 13. This FINANCING STATEMENT covers timber to be cut or as- extracted 16. Additional collateral description: collateral, or is filed as a ® fixture filing. 14. Description of real estate: SE 1/4 OF NE 1/4 & NE 1/4 OF SE 1/4 OF SEC. 16, TWP. 11, RG. 10, HALL CO., NE 15. Name and address of a RECORD OWNER of above- described real estate (if Debtor does not have a record interest): FEDERAL COMMUNICATION COMMISSION 17. Check gnly if applicable and check only one box. Debtor is a n Trust or Trustee acting with respect to property held in trust or Decedent's Estate 18. Check only if applicable and check only one box. ❑ Debtor is a TRANSMITTING UTILITY ❑ Filed in connection with a Manufactured -Home Transaction — effective 30 years Filed in connection with a Public- Finance Transaction — effective 30 years FILING OFFICE COPY— NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 07/29/98) NATUCC I - 5/4/01 C T System Online