200906491 - Laserfiche WebLink

Browse

200906491 UCC FINANCWG STATEMENT ADDENDUM 9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATEti FINANCING STATEMENT 9a. ORGANIZATION'S NAME OR Bb. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE HAINES DAVID 1 p. MISCELLANEOUS: ACCT # 901-023683 NCM-430947 THE ABOVE SPACE IS.FOR F1L1N0 OFFICE USE ONLY . _,. 11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME -insert only ~ name (11 a on 1 b) - do not abbreviate or combine names 11a. ORGANIZATION'S NAME ~' ~ 11b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 11 c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY 11 d. SEEINSTRUCTIONS ADD'L INFI] RE 11e. TYPE pF pRGANIZATION 11f. JURISDICTION OF ORGANIZATION 11g. CRGANIZATIDNAL ID #, if any ORGANIZATION DEBTOR NONE 12. ADDITIONAL SECURED PARTY'S ~ ASSIGNOR S/P'S NAME-insert onlyQpQname(12aor12b) 12a. ORGANIZATION'S NAME qR 126. INpIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 12c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY . _ .................~,..... ~„~ ~~.~~~. ~ ...,.e.a I__I .~~~~,.e~ .., wo ..... W~ U .,:,-anuarrcu ccllateral, or is filed as afixture filing. 14. Description of real estate: HAINES/DAVID P & CHRISTINA 612 N - CEDAR GRAND ISLAND NE 68801, KNOWN AS NORTHERLY HALF OF LOT 8, IN BLOCK I L, IN THE ORIGINAL TOWN, NOW CITY OF GRAND ISLAND, HALL COUNTY, NEBRASKA, PARCEL NUMBER :400000873 u. nuuuiunai cvuawrar aescnpnon: 15. Name and address of a RECORD OWNER of above-descrihed real estate (if Debtor does not have a record interest): I I. Check 4®13C if applicable and check ply one box. debtor is a Trust or Trustee acting with respect to property held in trust or Decedents Estate 18. Gheck sllll!(H applicable and check 41]lY one box. Debtor is a TRANSMITTING UTILITY Filed in connection with aManufactured-Nome Transaction -effective 30 years Filed in connection with aPublic-Finance Transacticn -effective 30 years FILING OFFICE COPY- UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. p5/22/p2)