200202190 - Laserfiche WebLink

Browse

UCC FINANCING STATEMENTADDENDUM FOLLOW INSTRUCTIONS (front and back) CAREFULLY 9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT Nil. ORGANIZATION'S NAME OR 9b. INDIVIDUALS LAST NAME FIRST NAME MIDDLE KRUEGER KEVIN D 10. MISCELLANEOUS: 11. ADDITIONAL DEBTOR'S I la. ORGANIZATIONS NAME 200202190 THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY LEGAL NAME- insert only = name Ills or 11b )- do not abbreviate or combine names OR Fb MOUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 11c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY 1 td. TAX ID #: SSN OR EIN A I Ile. TYPE OF ORGANIZATION I if.JURISDICTION OF ORGANIZATION 11 g. ORGANIZATIONAL 10 #. if any ORGANIZATION DEBTOR NONE 12. Fj ADDITIONAL SECURED PARTY'S . F1 ASSIGNORS /P'S NAME - insertonl M2 name (12a or 12b) 12a. ORGANIZATION'S NAME OR 12b INDIVIDUALS LAST NAME FIRST NAME MIDDLE NAME SUFFIX 12c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY 13. This FINANCING STATEMENT covers 0 Umber to be cut or ❑ as - extracted 16. Additional collateral description: collateral. or is filed as a ® fixture filing. 14. Description of real estate: NE1 /4 27 -9 -10 HALL COUNTY 15. Name and address of a RECORD OWNER of above-described real estate (d Debtor does not have a record interest): MARY LANNING HOSPITAL TRUST 17. Check nobl If applicable and a,eck =bt one box. 715 N ST JOSEPH HASTINGS, NE Debtor Is s n Trust or F1 Trustee acting vdth respect to property held In trust or Decedenrs Estate 18. Check =U if applicable and check =U on@ box. se Debtor Is a TRANSMITTING UTILITY Flied in connscion with a Manufacbrredflom! Transaction — effective 30 years Fled In connection with a Public-Finance Transaction — effective 30 years FILING OFFICE COPY— NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 0729198)