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7INANCING STATEMENT <br />INSTRUCTIONS (front and back) CAREFULLY <br />0 <br />v <br />$ PHONE OF CONTACT AT FILER [optional] <br />W <br />ACKNOWLEDGMENT TO: (Name and Address) <br />Cornerstone Bank <br />P.O. Box 69 <br />529 Lincoln Avenue <br />York, NE 68467-0069 <br />debtor name (1 a or 1b) -do not abbreviate or combine names <br />1. DEBTOR'S EXACT FULL LEGAL NAME - insert <br />1a. ORGANIZATION'S NAME <br />OR 1 b. INDIVIDUAL'S LAST NAME <br />Panowicz <br />1c. MAILING ADDRESS <br />10288 W White Cloud Rd <br />1d. SEE INSTRUCTIONS ADD'L INFO RE 1e. TYPE OF <br />ORGANIZATION nivi <br />dual <br />IDEBTOR 2. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAN <br />FIRST NAME <br />Michael <br />Cairo <br />1f. JURISDICTION <br />rv <br />x <br />c> (n <br />C3 <br />O <br />D <br />- <br />C= <br />C h <br />" <br />r <br />r, , <br />- . <br />~ <br />~ rn <br />0 <br />X1 <br />1 <br />v <br /> <br />o <br />o <br />C> <br />rn <br />C7~ <br />~ z <br />~_.a..;. <br />...r <br />a. CD <br />O a <br />M <br />CIS <br />Cil <br />.iv <br />j. <br />45 <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />MIDDLE NAME SUFFP <br />A <br />STATE POSTAL CODE COUNT <br />NE 68824-9760 USA <br />1 g. ORGANIZATIONAL ID if any <br />- insert onlv one debtor name (2a or 2b) - do not abbreviate or combine names <br />OR <br />2b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />Panowicz <br />Patricia <br />2c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />10288 W White Cloud Rd <br />Cairo <br />NE <br />68824-9760 <br />USA <br />2d. SEE INSTRUCTIONS <br />ADD'L INFO RE 2e. TYPE OF ORGANIZATION <br />2f. JURISDICTION OF ORGANIZATION <br />2g. ORGANIZATIONAL ID if any <br />I <br />ORGANIZATION <br />Individual <br />DEBTOR <br />NONE <br />3. SECURED PARTY S NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR S/P) - insert only one secured party name (3a or 3b) <br />3a. ORGANIZATION'S NAME <br />Cornerstone Bank <br />3c. MAILING ADDRESS a l r a i r+l a rrw 1 nLcunt 1,UUN 1 nlx <br />1631 16th Street Central City NE 68826-1815 USA <br />4. This FINANCING STATEMENT covers the following collateral <br />Purchase Money Security Interest in a 48' Brock Grain Bin. Model #4829; whether any of the foregoing is owned now or acquired later; all <br />accessions, additions, replacements, and substitutions relating to any of the foregoing; all records of any kind relating to any of the foregoing; <br />all proceeds relating to any of the foregoing (including insurance, general intangibles and accounts proceeds). <br />5. ALTAN&WE DESIGNATION [if applicable]: LESSEE/LESSOR 11 CONSIGNEE/CONSIGNOR BAILEE/BAILOR SELLER/BUYER AG. LIEN 11 NON-UCC FILING <br />6, cs F ft~In STATEMENT its to be filed [for record] (or recorded) in the REAL 7. Check to REQUEST SEARCH REPORT(S) on Debtor(s) <br />';a- -Im-. 11 rnnr)1T1r)K1AI Gr=M r-fi-n AIIDebtors Debtorl Debtor2 <br />C <br />>7 Z <br />A o <br />~,aN 00 <br />/O <br />Harland Financial Solutions <br />FILING OFFICE COPY - UCC FINANCING STATEMENT (FORM UCC1) (REV. 05/22/02) 400 S.W. 6th Avenue, Portland, Oregon 97204 <br />