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<br />;0 <br />m <br />.." <br />c: <br />Z <br />Qno <br />m~~ <br />Q:c <br /> <br />nn <br />::t:)> <br />m VI <br />n:r <br />'" <br /> <br /> <br /> 1.-,'.....,,':) <br /> <.:.~::-) <br /> 41'",:"".,;:) <br /> <:.n <br /> I'''" r~.:::l <br /> ?' "J <br /> "'. --j <br /> ,........ <br />. "jl -..J <br />CO <br /> ::n <br />, " " =.3 <br />\~ .' ~.,J <br />(i':' ,(,' ,........ <br /> i'''-" f----' <br /> " <br /> <br />N <br />G <br />G <br />()"I <br />....>0. <br />G <br />N <br />en <br />....>0. <br /> <br />'NANCING STATEMENT <br />INSTRUCTIONS front and back CARE FULL Y <br />~ PHONE OF CONTACT AT FILER [optional) <br />~A STEFFY 317-844-7951 EXT,308 <br />\CKNOWLEDGMENT TO: (Name and Ad~ <br /> <br />- LAX'mfL ~^'(.jll-t... CO~P <br />:ARMEL FINANCIAL CORPORATION <br />101 EAST CARMEL DRIVE, SUITE 200 <br />. --CARMEL, IN 46032~6127 <br /> <br />lr\ <br />\) <br /> <br />I <br /> <br />_C <br />C) <br />200510261 <br /> <br />u-1 <br /> <br />L <br /> <br />..J <br /> <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br /> <br />- <br />1. DEBTOR'S EXACT FULL LEGAL NAME "insertonly~d~btorname(1.or1b).do not.bbr.vioteorcombine names <br />la. ORGANIZATION'S NAME - <br /> <br />OR 1b.INDIVIDUAL'SLASTNAME <br /> <br />MIDDLE NAME <br /> <br />FIRST NAME <br /> <br />ANDAZOLA <br />10. MAILING ADDRESS <br /> <br />JORGE <br />CITY <br /> <br />STATE POSTAL CODE <br /> <br /> <br />GRAND ISLAND <br />1f, JURISDICTION OF ORGANIZATION <br /> <br />NE 68801 <br />1 g, ORGANIZATIONAL 10 #, if any <br /> <br />1 d. SEE INSTRUCTIONS <br /> <br />le, TYPE OF ORGANIZATION <br /> <br />2, ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only 2lllt debtor nome (2. or 2b) - do not abbreviot. or combine names <br /> <br />0 (f, <br />a "-l <br />c :f'... <br />Z --I <br />---l rn <br />-< <br /> <br />c:> "1'1 <br />-"1 <br /> ....:',-. <br /> i i <br />...'.... , <br />r'" 'I'"'t <br />r J>" <br /> <br />(.l) <br />;:><; <br />> <br /> <br />'--" '--" <br /> <br />(j') <br />(j') <br /> <br />~( <br /> <br />Cl~ <br />Ul,Ef <br />........(1) <br />Clf! <br /> <br />~i <br />'~2 <br />o <br /> <br />-1? Sa <br /> <br />SUFFIX <br /> <br />COUNTRY <br /> <br />NONE <br /> <br /> 2a. ORGANIZATION'S NAME <br />OR 2b, INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX <br /> ANDAZOLA CARMEN <br />2c MAILING ADDRESS CITY STATE I POSTAL CODE COUNTRY <br />307 E. 6TH STREET GRAND ISLAND NE 68801 <br />2d. SEE INSTRUCTIONS I :DD'L INFO RE 12e, TYPE OF ORGANIZATION 2f, JURISDICTION OF ORGANIZATION 2g, ORGANIZATIONAL ID #, if any <br /> ORGANIZATION I n NONE <br /> DEBTOR I I <br /> <br />3. SECURED PARTY'S NAME (orNAMEofTOTAlASSIGNEEof ASSIGNOR SIP) . insertonlY2llltsecured party name (SoorSb) <br /> <br /> Sa. ORGANIZATION'S NAME <br />OR CARMEL FINANCIAL CORPORATION <br />Sb, INDIVIDUAL'S lAST NAME FIRST NAME MIDDLE NAME SUFFIX <br />Sc. MAILING ADDRESS CITY STATE \POSTAl CODE COUNTRY <br />101 EAST CAR.J.'\1.EL DRIVE. SUITE 200 CARMEL IN 46032-6127 .. <br />~ ~!_,~.--..,.~ --- <br /> <br />4. This FINANCING STATEMENT cove.... the following oollateral: <br /> <br />WATER TREATMENT SYSTEM <br />MODEL: HYDRO / PROLINE REG REVERSE OSMOSIS UNIT <br />SERIAL: 234133/507007 <br /> <br /> <br />International Association of Commercial Administrators (IACA) <br />FILING OFFICE COpy - ucc FINANCING STATEMENT (FORM UCC1) (REV. OS/22/02) <br />