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200314986
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Last modified
10/16/2011 9:09:55 AM
Creation date
10/28/2005 4:20:57 PM
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200314986
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2. ADDITIONAL UELl I UK'b EXACT FULL LEGAL NAMF -insert only nne dehtnr name (9a nr ?h) -do not ahhreviatP nr nnmhine names <br />1a ORGANIZATION'S NAME <br />3b. INDIVIDUAL'S LAST NAME <br />;a <br />n n <br />SUFFIX <br />3c MAILING ADDRESS <br />CITY <br />1b. INDIVIDUAL'S LAST NAME <br />POSTAL CODE <br />lb. INDIVIDUAL'S LAST NAME <br />MIDDLE NAME <br />M <br />= <br />SUFFIX <br />I USA <br />Hartman <br />Y. <br />Thomas <br />L. <br />C <br />n = '� <br />CITY <br />STATE <br />POSTAL CODE <br />[� <br />_ <br />`470 - -L � <br />Q). <br />GRAND ISLAND, <br />Z <br />I 68801 <br />USA <br />1d. TAX ID #: SSN OR EIN <br />2g. ORGANIZATIONAL ID #, if any <br />Ile. TYPE OF ORGANIZATION <br />1f. JURISDICTION OF ORGANIZATION <br />1g. ORGANIZATIONAL ID #, if any <br />JADIYLINFORE <br />ORGANIZATION <br />DEBTOR <br />FINONE <br />rn <br />rye <br />NONE <br />N <br />° <br />O <br />C= 1'. <br />CAD <br />+� <br />;> <br />fV <br />N <br />�_ C <br />—t M <br />O <br />CL <br />O <br />i <br />. <br />I <br />j <br />C r <br />i <br />UCC FINANCING STATEMENT <br />jj <br />FOLLOW INSTRUCTIONS (front and back) CAREFULLY <br />c <br />m <br />i <br />A. NAME & PHONE OF CONTACT AT FILER (option[) <br />o <br />r <br />r >- <br />Jim Levick 308 - 772 -3234 <br />v' CJ <br />Cf) <br />co <br />B. SEND ACKNOWLEDGMENT TO: (Name and Address) <br />v <br />O <br />CD <br />CJ 7 <br />Ca <br />O <br />z <br />Nebraska State Bank <br />P.O. Box 260 <br />200314986 <br />Oshkosh, NE 69154 <br />L <br />THE ABOVE SPACE IS FOR OFFICE USE ONLY <br />1 DEBTOR'S EXACT FULL LEGAL NAME -insert only one debtor name (1a or 1b) -do not abbreviate or combine names <br />2. ADDITIONAL UELl I UK'b EXACT FULL LEGAL NAMF -insert only nne dehtnr name (9a nr ?h) -do not ahhreviatP nr nnmhine names <br />1a ORGANIZATION'S NAME <br />3b. INDIVIDUAL'S LAST NAME <br />OR <br />OR <br />SUFFIX <br />3c MAILING ADDRESS <br />CITY <br />1b. INDIVIDUAL'S LAST NAME <br />POSTAL CODE <br />lb. INDIVIDUAL'S LAST NAME <br />MIDDLE NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />I USA <br />Hartman <br />Y. <br />Thomas <br />L. <br />1c. MAILING ADDRESS <br />(J <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />_ <br />`470 - -L � <br />Q). <br />GRAND ISLAND, <br />NE <br />I 68801 <br />USA <br />1d. TAX ID #: SSN OR EIN <br />2g. ORGANIZATIONAL ID #, if any <br />Ile. TYPE OF ORGANIZATION <br />1f. JURISDICTION OF ORGANIZATION <br />1g. ORGANIZATIONAL ID #, if any <br />JADIYLINFORE <br />ORGANIZATION <br />DEBTOR <br />FINONE <br />507 -06 -3296 <br />DEBTOR <br />NONE <br />2. ADDITIONAL UELl I UK'b EXACT FULL LEGAL NAMF -insert only nne dehtnr name (9a nr ?h) -do not ahhreviatP nr nnmhine names <br />3. btUUNtU I-'HK I T b NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR S /P) - insert only one secured oarty name (3a or 3h) <br />OR <br />la ORGANIZATION'S NAME <br />3b. INDIVIDUAL'S LAST NAME <br />OR <br />MIDDLE NAME <br />SUFFIX <br />3c MAILING ADDRESS <br />CITY <br />1b. INDIVIDUAL'S LAST NAME <br />POSTAL CODE <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />Hartman <br />I USA <br />Carlotta <br />Y. <br />2c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />4701 S. Locust <br />GRAND ISLAND, <br />NE <br />I 68801 <br />USA <br />2d TAX ID # SSN OR EIN <br />12e. TYPE OF ORGANIZATION 2f. JURISDICTION OF ORGANIZATION <br />2g. ORGANIZATIONAL ID #, if any <br />508 -11 -1382 <br />ORGANIZATION <br />DEBTOR <br />FINONE <br />3. btUUNtU I-'HK I T b NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR S /P) - insert only one secured oarty name (3a or 3h) <br />OR <br />3a. ORGANIZATION'S NAME <br />Nebraska State Bank <br />3b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />3c MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />P.O. Box 260 <br />Oshkosh <br />I USA <br />4. [his FINANCING 51 AILMENT covers the following collateral: <br />SW1 14, Section 4, Township 10 North, Range 9 West of the 6th P.M., Hall County, Nebraska. <br />Pivot: 7 Tower Zimmatic #42003 <br />Motor: 50 Hp. Western Roller #9205473 <br />5 ALTERNATIVE DESIGNATION (if applicable) LESSEE/LESSOR I CONSIGNEE/CONSIGNOR I BAILEE /BAILOR I ISELLER/BUYER I IAG.LIEN I INON-UCCFILING <br />IS e O recur e O On O S <br />X REAL ESTATE RECORDS, Atta_c_h Addendum (if applicable) (ADDITIONAL FEE) (optional) All Debtors Debtor 1 Debtor 2 <br />8 OPTIONAL FILER REFERENCE DATA <br />Bank ID # 47- 0249940 <br />FILING OFFICE COPY -- NATIONAL UCC FINANCING STATEMENT (FORM UCC1) (REV. 07/29/96) <br />
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