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<br />:KNOWLEDGMENT TO: (Name and Address)
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<br />Platte Valley State Bank & Trust Company
<br />810 Allen Dr 1''' 8<< 51aJ"
<br />Grand Island. NE 68803 (; r:: Nt!- &FFt:J2.-<J97-"L
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<br />lANCING STATEMENT
<br />iTRUCTIONS front and back CAREFULLY
<br />PHONE OF CONTACT AT FILER [optional]
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<br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
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<br />1. DEBTOR'S EXACT FULL LEGAL NAME. insert only one debtor name (1a or 1 b) - do not abbreviate or combine names
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<br /> 1a, ORGAN!ZATION'S NAME -- --
<br /> Kelly & Kelly Real Estate, L.L.C.
<br />OR 1 b, INDIVIDUAL'S lAST NAME FIRST NAME MIDDLE NAME SUFFIX
<br />10. MAILING ADDRESS CITY STATE I POSTAL CODE COUNTRY
<br />2019 Stagecoach Rd. Grand Island NE 68801 USA
<br />1d. SEE INSTRUCTIONS JADD'l INFO RE 11e. TYPE OF ORGANIZATION 1f, JURISDICTION OF ORGANIZATION 19. ORGANIZATIONAL 10 #, if any
<br /> ORGANIZATION I LLC I NE I ~ NONE
<br /> DEBTOR
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<br />2, ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only one debtor name (2a Or 2b) - do not abbreviate or oombine names
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<br /> 2a, ORGANIZATION'S NAME
<br /> Kelly Family Dentistry, P.C.
<br />OR 2b, INDIVIDUAL'S lAST NAME FIRST NAME MIDDLE NAME SUFFIX
<br />20, MAILING ADDRESS CITY STATE I POSTAL CODE COUNTRY
<br />2412 W Faidley Ave Grand Island NE 68803 USA
<br />2d, SEE INSTRUCTIONS I ADD'l INFO RE 12e. TYPE OF ORGANIZATION 21. JURISDICTION OF ORGANIZATION 2g. ORGANIZATIONAL ID #, if any
<br /> ORGANIZATION . I NE I)d NONE
<br /> DEBTOR I Corporation I
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<br />3. SECURED PARTY'S NAME (or NAME ofTOTAl ASSIGNEE of ASSIGNOR SIP). insert only one seoured party name (3a or 3b)
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<br /> 3a, ORGANIZATION'S NAME
<br /> Platte Valley State Bank & Trust Company
<br />OR 3b. INDIVIDUAL'S lAST NAME FIRST NAME MIDDLE NAME SUFFIX
<br />3c. MAILING ADDRESS CITY STATE rOST Al CODE COUNTRY
<br />810 Allen Dr Grand Island NE 68803 USA
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<br />4. This FINANCING STATEMENT oovers the following collateral:
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<br />All inventory, equipment, accounts (including but not limited to all health-care-insurance receivables), chattel paper, instruments (including but
<br />not limited to all promissory notes), letter-of-credit rights, letters of credit, documents, deposit accounts, investment property, money, other
<br />rights to payment and performance, and general intangibles (including but not limited to all software and all payment intangibles); all oil, gas
<br />and other minerals before extraction; all oil, gas, other minerals and accounts constituting as-extracted collateral; all fixtures; all timber to be
<br />cut; all attachments, accessions, accessories, fittings, increases, tools, parts, repairs, supplies, and commingled goods relating to the
<br />foregoing property, and all additions, replacements of and substitutions for all or any part of the foregoing property; all insurance refunds
<br />relating to the foregoing property; all good will relating to the foregoing property; all records and data and embedded software relating to the
<br />foregoing property, and all equipment, inventory and software to utilize, create, maintain and process any such records and data on electronic
<br />media; and all supporting obligations relating to the foregoing property; all whether now existing or hereafter arising, whether now owned or
<br />hereafter acquired or whether now or hereafter subject to any rights in the foregoing property; and all products and proceeds (including but
<br />not limited to all insurance payments) of or relating to the foregoing property.
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<br />FILING OFFICE COpy - UCC FINANCING STATEMENT (FORM UCC1) (REV. OS/22/02)
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<br />Harland Financial Solutions
<br />400 S.W. 6th Avenue, Portland, Oregon 97204
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