UCC FINANCING STATEMENT
FOLLOW INSTRUCTIONS
________________________________
________________________________
________________________________
THE ABOVE SPACE IS FOR
FILING OFFICE USE ONLY
1a. ORGANIZATION'S NAME | |
________________________________ | |
OR | |
1b. INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME |
________________________________ | ____________________________ |
ADDITIONAL NAME(S)/INITIAL(S) THAT ARE | |
PART OF THE NAME OF THIS DEBTOR | SUFFIX |
________________________________ | _____________ |
1c. MAILING ADDRESS |
________________________________________ |
CITY | STATE | POSTAL CODE | COUNTRY |
__________ | __________ | __________ | __________ |
2a. ORGANIZATION'S NAME |
________________________________ |
OR |
2b. INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME |
________________________________ | ____________________________ |
ADDITIONAL NAME(S)/INITIAL(S) THAT ARE | |
PART OF THE NAME OF THIS DEBTOR | SUFFIX |
________________________________ | _____________ |
2c. MAILING ADDRESS |
________________________________________ |
CITY | STATE | POSTAL CODE | COUNTRY |
__________ | __________ | __________ | __________ |
3a. ORGANIZATION'S NAME |
________________________________ |
OR |
3b. INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME |
________________________________ | ____________________________ |
ADDITIONAL NAME(S)/INITIAL(S) | SUFFIX |
________________________________ | _____________ |
3c. MAILING ADDRESS |
________________________________________ |
CITY | STATE | POSTAL CODE | COUNTRY |
__________ | __________ | __________ | __________ |
________________________________
Collateral is | ____ held in a Trust (see Instructions) |
____ being administered by a Decedent's Personal | |
Representative. |
____ Public-Finance Transaction
____ Manufactured-Home Transaction
____ A Debtor is a Transmitting Utility
____ Agricultural Lien ____ Non-UCC Filing
________________________________________
[UCC FINANCING STATEMENT (Form UCC1)]
UCC FINANCING STATEMENT ADDENDUM
FOLLOW INSTRUCTIONS
9a. ORGANIZATION'S NAME |
________________________________ |
OR |
9b. INDIVIDUAL'S SURNAME |
________________________________ |
FIRST PERSONAL NAME |
________________________________ |
ADDITIONAL NAME(S)/INITIAL(S) | SUFFIX |
________________________________ | _____________ |
THE ABOVE SPACE IS FOR
FILING OFFICE USE ONLY
10a. ORGANIZATION'S NAME |
________________________________ |
OR |
10b. INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME |
________________________________ | ____________________________ |
ADDITIONAL NAME(S)/INITIAL(S) THAT ARE | |
PART OF THE NAME OF THIS DEBTOR | SUFFIX |
________________________________ | _____________ |
10c. MAILING ADDRESS |
________________________________ |
CITY | STATE | POSTAL CODE | COUNTRY |
__________ | __________ | __________ | __________ |
11a. ORGANIZATION'S NAME |
________________________________ |
OR |
11b. INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME |
________________________________ | ____________________________ |
ADDITIONAL NAME(S)/INITIAL(S) | SUFFIX |
________________________________ | _____________ |
11c. MAILING ADDRESS |
________________________________________ |
CITY | STATE | POSTAL CODE | COUNTRY |
__________ | __________ | __________ | __________ |
________________________________
________________________________
________________________________
________________________________
[UCC FINANCING STATEMENT ADDENDUM (Form UCC1Ad)]
UCC FINANCING STATEMENT AMENDMENT
FOLLOW INSTRUCTIONS
________________________________
________________________________
________________________________
THE ABOVE SPACE IS FOR
FILING OFFICE USE ONLY
________________________________
Filer: attach Amendment Addendum (Form UCC3Ad) and provide Debtor's name in item 13.
Check one of these two boxes:
This Change affects ____ Debtor or ____ Secured Party of record.
AND
Check one of these three boxes to:
____ CHANGE name and/or address: Complete item 6a or 6b, and item 7a or 7b and item 7c.
____ ADD name: Complete item 7a or 7b, and item 7c.
____ DELETE name: Give record name to be deleted in item 6a or 6b.
6a. ORGANIZATION'S NAME |
________________________________ |
OR |
6b. INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME |
________________________________ | ____________________________ |
ADDITIONAL NAME(S)/INITIAL(S) | SUFFIX |
________________________________ | _____________ |
7a. ORGANIZATION'S NAME |
________________________________ |
OR |
7b. INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME |
________________________________ | ____________________________ |
ADDITIONAL NAME(S)/INITIAL(S) THAT ARE | |
PART OF THE NAME OF THIS DEBTOR | SUFFIX |
________________________________ | _____________ |
7c. MAILING ADDRESS |
________________________________________ |
CITY | STATE | POSTAL CODE | COUNTRY |
__________ | __________ | __________ | __________ |
Also check one of these four boxes:
____ ADD collateral ____ DELETE collateral ____ RESTATE covered collateral ____ ASSIGN collateral
Indicate collateral:
If this is an Amendment authorized by a DEBTOR, check here ____ and provide name of authorizing Debtor
9a. ORGANIZATION'S NAME |
________________________________ |
OR |
9b. INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME |
________________________________ | ____________________________ |
ADDITIONAL NAME(S)/INITIAL(S) | SUFFIX |
________________________________ | _____________ |
________________________________
[UCC FINANCING STATEMENT AMENDMENT (Form UCC3)]
UCC FINANCING STATEMENT AMENDMENT ADDENDUM
FOLLOW INSTRUCTIONS
________________________________
12a. ORGANIZATION'S NAME |
________________________________ |
OR |
12b. INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME |
________________________________ | ____________________________ |
ADDITIONAL NAME(S)/INITIAL(S) | SUFFIX |
________________________________ | _____________ |
THE ABOVE SPACE IS FOR
FILING OFFICE USE ONLY
13a. ORGANIZATION'S NAME |
________________________________ |
OR |
13b. INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME |
________________________________ | ____________________________ |
ADDITIONAL NAME(S)/INITIAL(S) | SUFFIX |
________________________________ | _____________ |
________________________________
________________________________
________________________________
________________________________
[UCC FINANCING STATEMENT AMENDMENT ADDENDUM (Form UCC3Ad)]
Neb. U.C.C. § 9-521