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UCC FINANCING STATEMENT n FOLLOW INSTRUCTIONS front and back CAREFULLY f t'1 A. NAME & PHONE OF CONTACT AT FILER [optional] B. SEND ACKNOWLEDGEMENT TO: (Name and Address) I United Nebraska Bank PO Box 220 North Platte, NE 69103 THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 1. DEBTORS EXACT FULL LEGAL NAME - insert only one debtor name (1a or lb) - do not abbreviate or combine names 1a. ORGANIZATION'S NAME HEARTLAND PIZZA III, INC OR 1b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 1c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY 502 SOUTH VINE STREET NORTH PLATTE NE 69101 USA 1d. TAX ID #: SSN OR EIN ADD'L INFO RE Ile. TYPE OF ORGANIZATION tf. JURISDICTION OF ORGANIZATION 1g. ORGANIZATIONAL ID #, if any DEBTOR ORGANIZATION Corporation NONE 2. ADDITIONAL DEBTORS 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 SUFFIX 2c. MAILING ADDRESS CITY STATE I POSTAL CODE COUNTRY 2d. TAX ID #: SSN OR EIN ADD'L INFO RE 12e. TYPE OF ORGANIZATION 2f. JURISDICTION OF ORGANIZATION 2g. ORGANIZATIONAL ID #, if any ORGANIZATION DEBTOR NONE 3. SECU RED PARTY'S NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR S/P) - insert only one secured party name (3a or 31b) 3a. ORGANIZATION'S NAME United Nebraska Bank OR 3b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 3c. MAILING ADDRESS CITY STATE I POSTAL CODE COUNTRY PO Box 220 North Platte NE 69103 4. This FINANCING STATEMENT covers the following collateral: All Inventory, Chattel Paper, Accounts, Equipment, General Intangibles and Fixtures; whether any of the foregoing is owned now or acquired later; all accessions, additions, replacements, and substitutions relating to any of the foregoing; all records of any kind relating to any of the foregoing; all proceeds relating to any of the foregoing (including insurance, general intangibles and other accounts proceeds) 5. ALTERNATIVE DESIGNATION if a licable : I I LESSEE/LESSOR CONSIGNEE/CONSIGNOR I I BAILEE/BAILOR I I SELLER/BUYER AG. LIEN LA NON -UCC FILING 6 This FINANCING STATEMENT is to be filed (for record] (or recorded) in the REAL 7 Check to REQUEST SEARCH REPORT(S) on Debtor(s) dden ESTATE RECORDS, Attac [ADDITIONAL All Debtors Debtor 1 Debtor 2 8. OPTIONAL FILER REFERENCE DATA Harland Financial Solutions SECURED PARTY COPY — NATIONAL UCC FINANCING STATEMENT (FORM UCC►) (REV. 07/29/98) 400 S.W. 6th Avenue, Portland, Oregon 97204 0 l 1.. sa ry w o --4 orn T rn D Z rn C/) r c �. rn !� r c; C� CD CA.) �1 (� c_:+ ii r- n co t-. x T' Cn CD 20030945' THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 1. DEBTORS EXACT FULL LEGAL NAME - insert only one debtor name (1a or lb) - do not abbreviate or combine names 1a. ORGANIZATION'S NAME HEARTLAND PIZZA III, INC OR 1b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 1c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY 502 SOUTH VINE STREET NORTH PLATTE NE 69101 USA 1d. TAX ID #: SSN OR EIN ADD'L INFO RE Ile. TYPE OF ORGANIZATION tf. JURISDICTION OF ORGANIZATION 1g. ORGANIZATIONAL ID #, if any DEBTOR ORGANIZATION Corporation NONE 2. ADDITIONAL DEBTORS 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 SUFFIX 2c. MAILING ADDRESS CITY STATE I POSTAL CODE COUNTRY 2d. TAX ID #: SSN OR EIN ADD'L INFO RE 12e. TYPE OF ORGANIZATION 2f. JURISDICTION OF ORGANIZATION 2g. ORGANIZATIONAL ID #, if any ORGANIZATION DEBTOR NONE 3. SECU RED PARTY'S NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR S/P) - insert only one secured party name (3a or 31b) 3a. ORGANIZATION'S NAME United Nebraska Bank OR 3b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 3c. MAILING ADDRESS CITY STATE I POSTAL CODE COUNTRY PO Box 220 North Platte NE 69103 4. This FINANCING STATEMENT covers the following collateral: All Inventory, Chattel Paper, Accounts, Equipment, General Intangibles and Fixtures; whether any of the foregoing is owned now or acquired later; all accessions, additions, replacements, and substitutions relating to any of the foregoing; all records of any kind relating to any of the foregoing; all proceeds relating to any of the foregoing (including insurance, general intangibles and other accounts proceeds) 5. ALTERNATIVE DESIGNATION if a licable : I I LESSEE/LESSOR CONSIGNEE/CONSIGNOR I I BAILEE/BAILOR I I SELLER/BUYER AG. LIEN LA NON -UCC FILING 6 This FINANCING STATEMENT is to be filed (for record] (or recorded) in the REAL 7 Check to REQUEST SEARCH REPORT(S) on Debtor(s) dden ESTATE RECORDS, Attac [ADDITIONAL All Debtors Debtor 1 Debtor 2 8. OPTIONAL FILER REFERENCE DATA Harland Financial Solutions SECURED PARTY COPY — NATIONAL UCC FINANCING STATEMENT (FORM UCC►) (REV. 07/29/98) 400 S.W. 6th Avenue, Portland, Oregon 97204 0 l 1.. sa