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200803623
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Last modified
4/30/2008 4:29:21 PM
Creation date
4/30/2008 4:29:21 PM
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DEEDS
Inst Number
200803623
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<br />UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS Ifront and back) CARE FULL Y <br />9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT <br /> 9a. ORGANIZATION'S NAME <br />OR r:DlE NAME, SUFFI~ <br /> 9b. INDIVIDUAL'S lAST NAME I FIRST NAME <br /> JACOBSON GARY <br />10, MISCELLANEOUS: <br /> THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br /> <br />200803623 <br /> <br />11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only one name (11a or 11b) - do not abbreviate or combine names <br /> <br /> 11a. ORGANIZATION'S NAME <br />OR INDIVIDUAL'S lAST NAME FIRST NAME MIDDLE NAME <br /> 11b. SUFFIX <br />11c. MAILING ADDRESS CITY STATE rOSTAl CODE COUNTRY <br />11d. SEE INSTRUCTIONS I~DD'lINFORE 111e. TYPE OF ORGANIZATION 111. JURISDICTION OF ORGANIZATION 11g. ORGANIZATIONAL 10#, ifany <br /> ORGANIZATION n NONE <br /> DEBTOR I I I <br />12. lADDITIONAL SECURED PARTY'S or n ASSIGNOR SIP'S NAME - insert only one name (12a or 12b) <br /> 12a. ORGANIZATION'S NAME <br />OR INDIVIDUAL'S lAST NAME FIRST NAME MIDDLE NAME <br /> 12b. SUFFIX <br />12c. MAILING ADDRESS CITY STATE rOSTAl CODE COUNTRY <br />13. This FINANCING STATEMENT covers o timber to be cut or 0 as-extracled 16. Additional collateral description: <br /> collateral, or is fiied as a 0 fixture filing. <br />14. Description of real estate: <br />LOT EIGHTEEN (18) HAVING A LAKE FRONT OF <br />SEVENTY-EIGHT FEET (78') SITUATED ON THE WEST SIDE <br />OF THE WEST PORTION OF KUESTER LAKE AND BEING A <br />PART OF THE EAST ONE-HALF IE1/2) OF THE <br />SOUTHWEST QUARTER ISW1/4) OF SECTION THIRTEEN <br />(13), TOWNSHIP ELEVEN (11) NORTH RANGE NINE (9), <br />HALL COUNTY, NEBRASKA <br />15. Name and address of a RECORD OWNER of above-described real estate <br /> (if Debtor does not have a record interest): <br /> 17. Check!!!!!\, if applicable and check!!!!!\, one box. <br /> Debtor is a n Trust or n Trustee acting with respect to property held in trust or n Decedenfs Estate <br /> 18. Check!!!!!\, if applicable and check!!!!!\, one box. <br /> _ Debtor is a TRANSMITTING UTILITY <br /> _ Filed in connection with a Manufactured-Horne Transaction - effective 30 years <br /> Filed in connection with a Public-Finance Transaction - effective for 30 years <br /> <br />FILING OFFICE COPY - uec FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. OS/22/02) <br /> <br />Harland Financial Solutions <br />400 S.W. 6th Avenue, Portland, Oregon 97204 <br />
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