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UCC FINANCING STATEMENT FOLLOW INSTRUCTIONS (front and back) CAREFULLY A. NAME & PHONE OF CONTACT AT FILER [optional] II �IIiIM4 P0 BOX 270 �C? °� , r � co DONIPHAN, NE 68832.0270 �p O n C7: 200314843 � � THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY pig, o: � N N O � O C-) s co s CD C-P.. C 1. DEBTOR'S EXACT FULL LEGAL NAME - insert only one debtor name (1a or 1b) - do not abbreviate or combine names la. ORGANIZATION'S NAME OR B & B CARPET, INC 1b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX a tc. MAILING ADDRESS C) n ' ^'� " °' ^��""� "" " "•• mn M N NE 68832 f c n = [ARGANINFO OATION CORPORATION NE 481292291 ❑ Z ;✓a 2a. ORGANIZATION'S NAME OR 2b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME cn 2c. MAILING ADDRESS CITY o c') u1 COUNTRY 2d. TAX ID X: SSN OR EIN RE 2e. TYPE OF ORGANIZATION 2f. JURISDICTION OF ORGANIZATION 2g. ORGANIZATIONAL ID X, if any w CD —a DEBTOR 3. SECURED PARTY'S NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR SIP) - insert only one secured party name (3a or 3b) 3a. ORGANIZATION'S NAME OR BANK OF DONIPHAN 3b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX M CITY STATE n is JJ � DONIPHAN T IPOSTALCODE_ 68832 0270 HALL CD = rn M `1 r P0 BOX 270 �C? °� , r � co DONIPHAN, NE 68832.0270 �p O n C7: 200314843 � � THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY pig, o: � N N O � O C-) s co s CD C-P.. C 1. DEBTOR'S EXACT FULL LEGAL NAME - insert only one debtor name (1a or 1b) - do not abbreviate or combine names la. ORGANIZATION'S NAME OR B & B CARPET, INC 1b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX a tc. MAILING ADDRESS ��IT ' ^'� " °' ^��""� "" " "•• P.O. BOX 6 DONIPHAN NE 68832 f td. TAX ID d: SSN OR EIN RE 1e. TYPE OF ORGANIZATION 1f. JURISDICTION OF ORGANIZATION 1g. ORGANIZATIONAL ID r, if any [ARGANINFO OATION CORPORATION NE 481292291 ❑ DEBTOR NONE 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 SUFFIX 2c. MAILING ADDRESS CITY STATE IPOSTALCODE COUNTRY 2d. TAX ID X: SSN OR EIN RE 2e. TYPE OF ORGANIZATION 2f. JURISDICTION OF ORGANIZATION 2g. ORGANIZATIONAL ID X, if any [ADDANNFO ORGIZATION ❑ NONE DEBTOR 3. SECURED PARTY'S NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR SIP) - insert only one secured party name (3a or 3b) 3a. ORGANIZATION'S NAME OR BANK OF DONIPHAN 3b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 3c. MAILING ADDRESS CITY STATE COUNTRY P 0 BOX 270 DONIPHAN NE IPOSTALCODE_ 68832 0270 HALL 4. This FINANCING STATEMENT covers the following collatera See attached addendum B & B CARPET, IW . `11 rt V. SherAod tda K. Sherwood ` 5. ALTERNATIVE DESIGNATION [if applicable]: ❑ LESSEE /LESSOR ❑ CONSIGNEE /CONSIGNOR ❑ BAILEE /BAILOR ❑ SELLER /BUYER ❑ AG. LIEN ❑ NON -UCC FILING 6. This FINANCING STATEMENT is to be filed [for record] (or recorded) in the REAL .Check to REQUEST SEARCH REPORT opt onDlebtorlsl❑ All Debtors ❑ Debtor 1 ❑ Debtor 2 ® ESTATE RECORDS. Attach Addendum [if a licable] [ADDITIONAL FEE] OPTIONAL FILER REFERENCE DATA Bankers Systems, Inc., St. Cloud, MN Form UCC -I -LAZ 5/30/2001 FILING OFFICE COPY — NATIONAL UCC FINANCING STATEMENT (FORM UCC1) (REV. 07/29/98)