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<br />.. <br /> <br /> ;lO n ~ <br /> m X <br /> -n <br /> C ~ en <br /> Z :t: ,"'''-oj I <br />n 7li; ~ (") (f1 <br />:c: ~ c C=> 0 ...... 0 <br />~ ';.~ c:r.> <br />m - c= ~ N <br />n en ::3 z ~ <br />7li; :t: ~f ;:I:) ...... fT1 0 <br /> 0 -c: -< <br /> 0 a: <br /> 0 0'-:: I-" 0 ...., C) <br /> -..J .., <br /> --n ::z ~I <br /> 0 tic. ::r.: nl <br /> fT1 t' ::D :t>- CD <br /> ,." ::3 r- ;;:c <br /> 0 r- ~ <br /> (f) ~ (/) <br /> C :;:0<; <br /> :> <br /> I c..:> .......,,-, COM- <br /> ~ c::n <br /> (if) Z <br /> 0 <br /> <br />N <br />S <br />S <br />en <br />s <br />~ <br />w <br />...... <br /><0 <br /> <br /> <br />) ACKNOWLEDGMENT TO: (Name and Address) <br /> <br />(fUR--rn- ~ I <br /> <br />F. William Schellpeper, €sq. <br />REMBOL T LUDTKE LLP <br />1201 Lincoln Mall, Suite 102 <br />Lincoln, Nebraska 68508 <br /> <br />L <br /> <br />~ <br /> <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br /> <br />,. DEBTOR'S EXACT FULL LEGAL NAME.insertonlYQMdebtorname (1aor1 b)-do notabbroviato orcombino names <br />1a. ORGANIZATION'S NAME .~._-_.- <br /> <br />Iloe <br /> <br />Grand Island Re ene Retirement <br />OR 1b.INDIVIDUAL'SLASTNAME <br /> <br />FIRST NAME <br /> <br />MIDDLE NAME <br /> <br />SUFFIX <br /> <br />1c. MAILING ADDRESS <br /> <br />CITY <br /> <br />STATE POSTAL CODE <br /> <br />COUNTRY <br /> <br /> <br />10. TYPE OF ORGANIZATION <br /> <br />Grand Island <br />1/. JURISDICTION OF ORGANIZATION <br /> <br />NE 68803 <br />1 g. ORGANIZATIONAL ID #, if any <br /> <br />USA <br /> <br />Nebraska <br />2. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME . Insert only QM debtor name (2a or 2b) - do not abbreviate or combine name. <br /> <br />NONE <br /> <br /> '2;"ORGANIZATION'S NAME <br />OR 2b. INDIVIDUAL'S LAST NAMIO FIRST NAME MIDDLE NAME SUFFIX <br />2c. MAILING ADDRESS CITY STATE IPOSTALCODE COUNTRY <br />2d. SEE INSTRUCTIONS I ADD'L INFO RI;;; 12e, TYPE OF ORGANIZATION 2f. JURISDICTION OF ORGANIZATION 2g. ORGANIZATIONAL ID #, if any <br /> ORGANIZATION n NONE <br /> DEBTOR I I I <br /> <br />3, SEC U RED PARTY'S NAME (or NAMEofTOTALASSIGNEEofASSIGNOR S/P)-In.ertonlv=.ecured partyna"'e (3aor3b) <br /> <br /> 3a. ORGANIZATION'S NAME ----- <br />OR Hospital Authoritv No.1 of Hall Countv. Nebraska <br />3b. INDIVIDUAl'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX <br />3c. MAILING AODRE:SS CITY STATE IPOSTAL CODE COUNTRY <br />615 West Ist Street Grand Island NE 68802 USA <br /> <br />4. ThIS FINANCING STATEMIONT covers the following collateral: <br /> <br />See Exhibits" A" and "B" attached hereto. <br /> <br />5. ALTERNATIVE DESIGNATION fif applicable]: <br />6. This FINANC NG STATEMENT IS to be I e <br /> <br /> <br />Debtor 2 <br /> <br />8. OPTIONAL FILER REFERENCE DATA <br /> <br />International Association of Commercial Administrators (IACA) <br />FILING OFFICE COPY - UCC FINANCING STATEMENT (FORM UCC1) (REV, OS/22/02) <br />