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<br /> .i <br /> ~ nn <br /> ::c>- <br /> m en <br /> c: n:c 111 <br />N nn6 r.........)o ~I <br /> '" G"::'.3 0 (JJ <br />CSl ~NCING STATEMENT <::::> 0 -i <br />S :C>cn ~ <br />0'> STRUCTIONS (front and back) CAREFULLY rn .. >4., c: :I> <br />en -r, :z -i <br />S " r"T"l <br /> ~~ -i I'Tl <br />CSl ONE OF CONTACT AT FILER [optional] c::c <:::) <br />(,0 -< 0 ~ <br />-" one:(800) 331-3282 Fax: (818) 662-4141 0 ..., c::> <br />CD l""-' ..., Z en - <br /> IOWLEDGEMENT TO: (Name and Address) ~ :s <br /> 5106561PRI EA CEPT C:J tt ::::r: fT1 I <br /> ~~t1 LI CC /)fI!O::'~ I f"'1 ~'> ::D l> OJ c:> <br /> f'l ::3 r-' :;0 <:::) <br /> Cl r-' l> <br /> C I ct Servlcl:ls $t:'.R,V/Ct:s 70358 2 {J) ~ (j") CD <br /> CO ;::0<:: <br /> ), Box 29071 PI) Ba '/.. (~% 1/ l> ..-- <br /> U'1 .......,..,.""""" <br /> Glendale, CA 91209-9071 (j UIYb.ntENENE c:> (/) CD ~ <br /> L e/I 1/0.09 FIXTURE ~ (;f> <br /> <br /> <br />File with: Hall, NE THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />1. DEBTOR'S EXACT FULL LEGAL NAME. insert only one debtor name (1a or 1 b) - do not abbreviate or combine names <br /> <br />-' <br />C7 <br />~ <br /> <br /> - <br /> 1a. ORGANIZATION'S NAME <br />OR <br /> 1 b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX <br /> MENDOZA MARINA E <br />1c. MAILING ADDRESS CITY STATE I POSTAL CODE COUNTRY <br />316 S WALNUT ST GRAND ISLAND NE 68801 <br />1d. SEE INSTRUCTIONS jg!D'L INFO RE reo TYPE OF ORGANIZATION 11. JURISDICTION OF ORGANIZATION 1 g. ORGANIZATIONAL 10 #, i/any <br /> ORGANIZATION D NONE <br /> DEBTOR <br /> <br />- <br />- <br />- <br />- <br /> <br />- <br />- <br />- <br />- <br /> <br />2. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only ~ debtor name (2a or 2b) - do not abbreviate or combine names <br /> <br />- <br />- <br />- <br />- <br />~ <br />;;;;;;;;;; <br />;;;;;;;;;; <br /> <br /> 2a. ORGANIZATION'S NAME <br />OR <br /> 2b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX <br />2c. MAILING ADDRESS CITY STATE iPOSTALCODE COUNTRY <br />2d. SEE INSTRUCTIONS ~:D'L INFO RE 128. TYPE OF ORGANIZATION 2f. JURISDICTION OF ORGANIZATION 29. ORGANIZATIONAL 10 #, if any <br /> RGANIZATION D NONE <br /> DEBTOR <br /> <br />= <br />- <br />- <br /> <br />- <br />- <br /> <br />3. SECURED PARTY'S NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR SIP). insert only one secured party name (3a or 3b) <br /> <br />- <br />- <br />- <br /> <br /> - <br /> 3a. ORGANIZATION'S NAME <br /> PRIME ACCEPTANCE CORP. <br />OR <br /> 3b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX <br />3c. MAILING ADDRESS CITY STATE TPOSTAL CODE COUNTRY <br />200 West Jackson Blvd #720 Chicago I L 60606 <br /> <br />- <br />- <br />- <br /> <br />4. This FINANCING STATEMENT covers the following collateral: <br /> <br />WHOLE HOUSE WATER TREATMENT SYSTEM <br /> <br /> <br />LESSEE/LESSOR <br /> <br />NON.UCC FILING <br /> <br />7035812 <br /> <br />610041675 <br /> <br />FILING OFFICE COPY - NATIONAL UCC FINANCING STATEMENT (FORM UCC1) (REV. 05/22/02) <br /> <br />Preoared bv UCC Direct Services, P.O. Box 29071, <br />Glendale. CA 91209.9071 Tel (800) 331-3282 <br />