|
OR
<br />26. INDIVIDUAL'S
<br />2c. MAILING ADDRESS ICITY ISTATE (POSTAL CODE ICOUNTRY
<br />2d. TAX ID #: SSN OR EIN JADD'LINFORE 12e. TYPE OF ORGANIZATION 12f. JURISDICTION OF ORGANIZATION I2g. ORGANIZATIONAL ID #, if any
<br />ORGANIZATION
<br />DEBTOR ❑ 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 />3a, ORGANIZATION'S NAME
<br />OR Platte Valley State Bank &Trust Company
<br />3b. INDIVIDUAL'S LAST NAME FIRST NAME I MIDDLE NAME ISUFFIX
<br />3c. MAILING ADDRESS CITY STATE POSTAL CODE CUUN 1 HY
<br />810 Allen Drive Grand Island NE 68803 USA
<br />4. This FINANCING STATEMENT covers the following collateral: All of the following which Debtor owns now Or in the future, together with all parts,
<br />accessories, repairs, replacements, improvements, and accessions, and wherever located: INVENTORY: All inventory held for
<br />ultimate sale or lease, or which has been or will be supplied under contracts of service, or which are raw materials, work in
<br />process, or materials used or consumed in Debtor's business. EQUIPMENT: All equipment including, but not limited to,
<br />machinery, vehicles, furniture, fixtures, manufacturing equipment, farm machinery and equipment, shop equipment, office and
<br />record keeping equipment, parts, and tools. The property includes any equipment described in a list or schedule Debtor gives to
<br />Secured Party, but such a list is not necessary to create or perfect a valid security interest in all of Debtor's equipment.
<br />ACCOUNTS AND OTHER RIGHTS TO PAYMENT: All rights to payments, whether or not earned by performance, including,
<br />but not limited to, payment for property or services sold, leased, rented, licensed, or assigned. This includes any rights and
<br />interests (including all liens) which Debtor may have by law or agreement against any account debtor or obligor of Debtor.
<br />GENERAL INTANGIBLES: All general intangibles including, but not limited to, tax refunds, patents(CONTINUED)
<br />5. ALTERNATIVE DESIGNATION [if applicable]: ❑ LESSEE /LESSOR ❑ CONSIGNEE /CONSIGNOR ❑ BAILEE /BAILOR ❑ SELLER /BUYER ❑ AG. LIEN ❑ NON -UCC FILING
<br />6. This FINANCING STATEMENT is to be filed (for record] (or recorded) in the REAL .Check to REQUEST SEARCH REPORT S) on Debtor(s)❑ All Debtors ❑ Debtor 1 ❑ Debtor 2
<br />Ex ESTATE RECORDS. Attach Addendum 1:5 applicablel [ADDITIONAL FEEL o tionel]
<br />Bankers Systems, Inc., St, Cloud, MN Form UCC -1 -LAZ 5/3012001
<br />SECURED PARTY COPY — NATIONAL UCC FINANCING STATEMENT (FORM UCC1) (REV. 07/29/98)
<br />a
<br />cn
<br />..
<br />`-
<br />ry �
<br />n n a
<br />7
<br />-� ,
<br />LANCING STATEMENT
<br />n
<br />0
<br />I
<br />'
<br />cri
<br />CrI � 3TRUCTIONS (front and back) CAREFULLY
<br />f
<br />PHONE OF CONTACT AT FILER [optional]
<br />i1
<br />=3
<br />C77
<br />r
<br />CKNOWLEDGM N Name and Address)
<br />[– A
<br />jStat
<br />.atte Valley State Bank & Trust Company, Platte
<br />Val
<br />to
<br />Cn
<br />ank & Trust Company
<br />223 Second Ave
<br />-- Kearney, Nebraska 68848 -0430
<br />J
<br />�ey,
<br />THE ABOVE SPACE
<br />IS FOR
<br />FILING OFFICE
<br />USE ONLY
<br />,
<br />1. DEBTORS EXACT FULL LEGAL NAME - insert only one debtor name (1a or 1b) - do not abbreviate or combine names
<br />1 a. ORGANIZATION'S NAME
<br />OR
<br />1b. INDIVIDUAL'S LAST NAME
<br />FIRST NAME
<br />MIDDLE NAME
<br />SUFFIX
<br />Cobler Jr.
<br />Thomas
<br />Guy
<br />1c. MAILING ADDRESS
<br />CITY
<br />STATE
<br />POSTAL CODE
<br />COUNTRY
<br />3404 W 13th St, Suite 115
<br />Grand Island
<br />NE
<br />68803
<br />USA
<br />1d. TAX ID q: SSN OR EIN
<br />ADD'L INFO RE lie, TYPE OF ORGANIZATION
<br />if. JURISDICTION OF ORGANIZATION
<br />1g. ORGANIZATIONAL
<br />ID
<br />1f, if any
<br />ORGANIZATION
<br />❑
<br />507 -08 -1169
<br />DEBTOR I
<br />I
<br />NONE
<br />2. ADDITIONAL DEBTORS EXACT FULL LEGAL NAME - insert only one debtor name (2a or 2b) - do not abbreviate or combine names
<br />2a. ORGANIZATION'S NAME
<br />OR
<br />26. INDIVIDUAL'S
<br />2c. MAILING ADDRESS ICITY ISTATE (POSTAL CODE ICOUNTRY
<br />2d. TAX ID #: SSN OR EIN JADD'LINFORE 12e. TYPE OF ORGANIZATION 12f. JURISDICTION OF ORGANIZATION I2g. ORGANIZATIONAL ID #, if any
<br />ORGANIZATION
<br />DEBTOR ❑ 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 />3a, ORGANIZATION'S NAME
<br />OR Platte Valley State Bank &Trust Company
<br />3b. INDIVIDUAL'S LAST NAME FIRST NAME I MIDDLE NAME ISUFFIX
<br />3c. MAILING ADDRESS CITY STATE POSTAL CODE CUUN 1 HY
<br />810 Allen Drive Grand Island NE 68803 USA
<br />4. This FINANCING STATEMENT covers the following collateral: All of the following which Debtor owns now Or in the future, together with all parts,
<br />accessories, repairs, replacements, improvements, and accessions, and wherever located: INVENTORY: All inventory held for
<br />ultimate sale or lease, or which has been or will be supplied under contracts of service, or which are raw materials, work in
<br />process, or materials used or consumed in Debtor's business. EQUIPMENT: All equipment including, but not limited to,
<br />machinery, vehicles, furniture, fixtures, manufacturing equipment, farm machinery and equipment, shop equipment, office and
<br />record keeping equipment, parts, and tools. The property includes any equipment described in a list or schedule Debtor gives to
<br />Secured Party, but such a list is not necessary to create or perfect a valid security interest in all of Debtor's equipment.
<br />ACCOUNTS AND OTHER RIGHTS TO PAYMENT: All rights to payments, whether or not earned by performance, including,
<br />but not limited to, payment for property or services sold, leased, rented, licensed, or assigned. This includes any rights and
<br />interests (including all liens) which Debtor may have by law or agreement against any account debtor or obligor of Debtor.
<br />GENERAL INTANGIBLES: All general intangibles including, but not limited to, tax refunds, patents(CONTINUED)
<br />5. ALTERNATIVE DESIGNATION [if applicable]: ❑ LESSEE /LESSOR ❑ CONSIGNEE /CONSIGNOR ❑ BAILEE /BAILOR ❑ SELLER /BUYER ❑ AG. LIEN ❑ NON -UCC FILING
<br />6. This FINANCING STATEMENT is to be filed (for record] (or recorded) in the REAL .Check to REQUEST SEARCH REPORT S) on Debtor(s)❑ All Debtors ❑ Debtor 1 ❑ Debtor 2
<br />Ex ESTATE RECORDS. Attach Addendum 1:5 applicablel [ADDITIONAL FEEL o tionel]
<br />Bankers Systems, Inc., St, Cloud, MN Form UCC -1 -LAZ 5/3012001
<br />SECURED PARTY COPY — NATIONAL UCC FINANCING STATEMENT (FORM UCC1) (REV. 07/29/98)
<br />
|