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00797
UCC FINANCING STATEMENT AMENDMENT
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
A. NAME & PHONE OF CONTACT AT FILER [optionall
Phone (800) 331-3282 Fax (818) 662-4141
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RECEIVED 3/7/2006 at 2:52 PM
RECEIVING # 916471
BOOK: 613 PAGE: 797
JEANNE WAGNER
LINCOLN COUNTY CLE
-_nn. .. RK, KEMMERER, wy
B. SEND ACKNOWLEDGEMENT TO: (Name and Mailing Address) 511466 ICOMMUNITY1
UCC Direct Services
P.O. Box 29071
Glendale, CA 91209-9071
5851005.1
L
WYOM
FIXTURE
~
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
b. This FINANCING STATEMENT AMENDMENT is
f)(1 to be filed [for recOfd] (c¡r recordeq) in the
~ REAL ESTATE RECORDS.
1a.INITIAL FINANCING STATEMENT FILE #
891429 BK526-PG376 07-08-03 CC WY LINCOLN
2. X TERMINATION: Effectiveness of the Financing Statement Identified above is terminated with respect to security interest(s) of the Secured Party authorizing this Termination Statement.
3. 0 CONTINUATION: Effectiveness of the Financing Statement idenlified above with respecllo the securily inleresl(s) of the Secured Party aulhorizing this Continuation Statement is
continued for the additional period provided by appticable law.
4. 0 ASSIGNMENT (full or partial): Give name of assignee in item 7a or 7b and address of assignee in 7c; and also give name of assignor in item 9.
5. AMENDMENT (PARTY INFORMATION): This Amendment affectsD Debtor Q[ 0 Secured Party of record. Check only ~ of these two boxes.
Also check one of the following three boxes !!ill! provide appropriate information in items 6 and/or 7.
O CHANGE name and/or address: Give current record name in item 6a Of 6b; also give new 0 DELETE name: Give record name 0
name (if name change) in item 7a or 7b and/Of new address (if address change) in item 7c. to be deleted in item 6a or 6b.
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6. CÚRRE;..JtRECORD INFORMÂTIÒN:
6a, ORGANIZA'110N'S NAME .
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ADD name: Complete item 7a or 7b. and also ==
item 7c: also compteteltems 7d-7g (if appticable)
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OR 6b. INDIVIDUAL'S LAST NAME
Kellen
7. CHANGED (NEW) OR ADDED INFORMATION:
. 7a. ORGANIZATION'S NAME
FIRST NAME
SUFFIX
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William
G
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OR
7b. INDIVIDUAL'S LAST NAME
FIRST NAME
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MIDDLE NAME
SUFFIX
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7c. MAILING ADDRESS
CITY
STATE POSTAL CODE
COUNTRY
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7d. SEE INSTRUCTION
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.7e. TYPE OF ORGANIZATION
7f. JURISDICTION OF ORGANIZATION
79. ORGANIZATIONAL ID #. if any
o NONE
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9. NAME OF SECURED PARTY OF RECORD AUTHORIZING THIS AMENDMENT (name of assignor, If lhis is an Assignment), If this is an Amendment authorized by a DebtOf which
adds collateral Of adds the authorizing Debtor, Of if this is a Terrrination authorized by a Debtor, check hereD and enter name of DEBTOR authorizing this Amendment.
9a. ORGANIZATION'S NAME
Community First National Bank
OR
9b. INDIVIDUAL'S LAST NAME
10. OPTIONAL FILER REFERENCE DATA. ,
5851005.1 Debtor Name:Kellen, William G William Kellen 00815
FlUNG OFFICE COPY - NATIONAL UCC FINANCING STATEMENT AMENDMENT (FORM UCC3) (REV. OS/22/02)
prepared bv UCC Direct Services. P.O. Box 29071
Glendale, CA 91209-9071 Tel (800) 331-3282
..
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000798
UCC FINANCING STATEMENT AMENDMENT ADDENDUM
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
11. INITIAL FINANCING STATEMENT FILE # (same as item 1a on Amendment form)
891429 BK526-PG376 07-08-03 CC WY LINCOLN
12. NAME of PARTY AUTHORIZING THIS AMENDMENT (same as Item 9 on Amendment form)
12a. ORGANIZATION'S NAME
;. Community First National Bank
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13. Use this space for additional Information
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
Description: Lots 20 and 21 of Block 13 of the Original Town of Kemmerer, Lincoln County, Wyoming as described on the official plat
thereof.
ACKNOWLEDGMENT COPY - NATIONAL UCC AMENDMENT ADDENDUM (FORM UCC3Ad) (TRANS) (REV. OS/22/02)
Prepared by UCC,Direct Services, Inc. P.O. Box 29071
Glendale, CA 91209-9071 Tel (600) 331-3282