|
<br />UCC FINANCING STATEMENT ADDENDUM
<br />FOllOW INSTRUCTIONS (front and back\ CAREFUllY
<br />9. NAME OF FIRST DEBTOR (1" or1b) ON RELATED FINANCING STATEMENT
<br />0.. ORGANLZA nON'S NAME.
<br />
<br />OR
<br />:g~~~~:~;~~~~INAMEmml~~SINAME .m... '1 ~1~~~~Mfi:SiJFFiX
<br />
<br />10. MISCELLANEOUS:
<br />
<br />200511937
<br />
<br />--' j
<br />
<br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONL Y
<br />
<br />II, ~[)DITION~L[)~~TqFZ':;;E'0f\c:TFl)LLLEGAl,N}\fIJ1E':i~~OItorIYQllilMam~r1~?'"b):do not abb,e".te 0' combine Mme,
<br />'1' ". ORGANIZATION'S NAME
<br />
<br />Ol'~ liii> iNOiviiii:iAL'S LAST NAME'"
<br />I
<br />
<br />......................................................".".",.""......
<br />FIRST NAME
<br />
<br />,'L:.. MAILING ADDRESS
<br />
<br />CITV
<br />
<br />110 SEE INSTRUCTIONS
<br />
<br />
<br />111, JURISDICTION OF ORGANIZATION
<br />
<br />12. ADDITIONAL SECURED PARTY'S
<br />12.0RCANliAiioN'SNAM'Emmmmmm.....mm
<br />I
<br />
<br />..p.,.~.~I.g;1II913...$IP'S NAtvi.E'...:..i.'.'.".?rt.?'.'.IY.?D?".om ".(1.2a."'.~..2,t!l.....
<br />
<br />OR 1'2b INDIVIDUAL'S lAST NAME
<br />
<br />, , ~~
<br />120, MAiliNG ADDRESS
<br />
<br />FIRST NAME
<br />
<br />ClfY
<br />
<br />13. Thki FINANCING STATFMENT r.olJor~.,D tjlTlbar t" btl ClJt. Of 0 [<r;.-cxtmctod '16, ArJditional coHatcr,11 d(}~riptkHi:
<br />(;:()lIah',;rt-ll, (H is fll~~d a(\ 1.1 I8J fhfum fill1'lq
<br />14, De8>:::ripti..)t~ of ra~r eMata:
<br />
<br />W 1/2 OF NW 1/4 IN SEC 11 ., T 10. R 11, HALL COUNTY, NE
<br />
<br />15, Na",,, and addro.. 0/ a RECORl) OWNER o! >>bCllfO-d",",ibod ,eal ,,,,taro
<br />(it Oabtor dOQa not have a record intor0$.t}~
<br />
<br />lARRY WOITASZEWSKI
<br />
<br />--- F,,--
<br />
<br />MIDDLE NAME
<br />
<br />STiliE'^"'iF'()SfAL CODE
<br />
<br />I
<br />~_^^^._1
<br />11g. ORCANIZATIONAl 10 #, it any
<br />
<br />MIDl)lE NAME
<br />
<br />STATE IP'OSTAL COOF
<br />i
<br />i
<br />
<br />NONE
<br />
<br />SUFFIX
<br />
<br />I COUNTRY
<br />
<br />'17, Check ooIy i! applic.b",""" ohook ooIy one box
<br />[)~~btcr it, n nTrufit O[ n Tru('~t(t~U r3:dil'rJ with ro:s~)eGt to' proporty hold il1 tnJs.t or n l.)Or,::OdOI~t'(, F:strlto
<br />'18, Check ooIy if .ppliooble oM check ooIy one box
<br />Dcb!",;"" TRANSMITTING UTIIJTV
<br />
<br />Filod in ~)I"'Inccbon with a Mam..JactUfcd.}i!:)fT)f) "i"rMlsnction ,.,~, ~ffeGtivo 30 yearn
<br />Fi'f-)O itl ,:;Qlincctioll Witt' a Puhlic.fillanco Tl'alis~lctiOl~ ,....., offcctM!J 30 yrm.'5
<br />
<br />FILING OFFICE COpy - UCC FINANCING STATEMENT ADDENDUM (FORM UCC'lAd) (REV, OS/22/02)
<br />
|