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UCC FINANCING STATEMENT
FOLLoW INSTRUCTIONS {front andbacld CAREF.ULL Y
A. NAIiia: & PHONe Of CONrAëT AT FILER [optlonaq
800-648-8026
.8. SEND ACKNOWLEDGIllE!NT TO: (Name and Address)
~IVERSIFIED FINANCIAL SERVICES, LLC
14010 FIRST NATIONAL BANK PKWY
STE 400
OMAHA, NE 68154
---.
RECEIVED 9/5/2008 at 2:50 PM
RECEIVING # 942023
BOOK: 704 PAGE: 285
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
L
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OOô285
THE ABOVE SPACE 1& fOR PILING pfflOE USE ONLY
1. DE aTQR~S'EXACT FULL lEGAL NAMÈ -lnseltol1ly!W! debtor name (1 a or 111) ·do notebbMllleteor combine nam...
1e, ORGANIZATION'5 NAMe
QR 1b.INDMDUI\L'SI.AS1 NAME FIRST NAME MIDDLE NAME SUFFIX
CAZIER CHAD D.
1c. MAlUNOAI'JQRESS CI1Y STATË IPOSTAL CODE COlJllTRY
8185 HIGHWAY 238 AFTON WY 83110
1d. SEEIIoIaTRUên.ONS I ;DD1.1NFO RE 11.. 1YPE OF ORGANIZATION 11. JURISDICTION OF ORGANIZATION 19. OR3ANllATIONAl.ID #. II any
ORGANIZATION I I I ~
DEBTOR
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2. PDDITIONAl DEI:ITORI$ EXACT FULL LEGAl NAME· In..rt only QDA ·:lebtor name (2a or 2b) . do not Ibbrev.1Is or combine name.
2a.ORGANIlA TIO/II'SJiWÆ
OR 2b. INDMPUAL'S lAST NAME FIRST NAME MIDDLe NAME SUFFIX
CAZIER WILLIAM
20. MAaJNG iIDORESS CIN STATE IPOSTALCODE COlJllTRY
8185 HIGHWAY 238 AFTON WY 63110
2d. M/;1INSòTRUC:nDNS I:D'UNFO RE 2e. 1YPEOF ORGANIZATION 21. JURISDICTION OF OimANlZATION 2g. ORGANIZATlONALID t. Weny
ORGANIZATION Chs.
DElJrœ I I I
3.S5GURED PARTY'S NAMe (orNAMEofTOTALASSIGNEEof ASSIGNOR S'p) -In&8ltonIyQDA.8Curtldplltynamø peor 3b)
3& GRGANIlA TlON'S NAM!:
DIVERSIFIED FINANCIAL SERVICES. LLC
OR 3b.JNDIVIDUAI.'S LAST NAME FIRST NAME MIDDLE NAMe SUFFIX
30. r.4AI.JNQ ADDRESS CITY STATE ¡POSTAl CODE COU>lTRY
14010 FIRST NATIONAL BANK PKWY STE 400 OMAHA NE 66154
4. TN. I'INANctIG ST ATEMENf com, Ihe IoIICiWlng coIl,lIsrat
1 NEW 2008 MODEL 7000 VALLEY PIVOT 1056' 6-TOWER SIN 10680229
300' 8" PVC, 900' #2 QUAD WIRE. 15HP TURBINE PUMP. DRAGON FILTER. MISC. VALVES & FITTINGS
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'1,,"\
0162408-001
FILINI;) OFFICE COPY - UCC FINANCING STATEMENT (FORM UCC1) (REV. OS/22/02)
UCC FINANCING STATEMENTADDENDUM
FOlLOW INSTRUCTlONSfrrontand back) CAREFULLY
~. NAME OFFI~ST DEBTOR (1a or1b) ON RELATED FINANCING STATEMENT
9a. ORGANIlATION'SNAME
OR
9b. INDJVHJUAL'S LAST NAME
CAZIER
¡'FIRST NAME
CHAD
IM1DDL NAME,SUFFIX
10.
10. MlSOELlANEOUS:
000286
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
11. ADDITIONAL DEBTOR.'S EXACT FULL LEGAL NAM:. insert only W!J.ríeme (118 or 11 ¡. do notabbraviatøor combine nam....
11 B. ORGANIZATION'S NAME
OR 11b.INbIVIDUAL'S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
110. MAlUNG ADDRESS
CITY
STATE ¡POSTAL CODE
11g. ORGANIZATIONALlD/II, if any
COlA' TRY
11d. SEEINSTRUCTIONS I:ADD'L INFORE 111e. TYPE OF ORGANIZATION
ORGANIZATION I
DEBTOR
1·2. I ADDITIONAL SECURED PARTY'S
1128. ORGANIZATION'S NAME
111. JURISDI TlONOFORGANIZATION
I
¡¡¡ IIASSIGNORS/P'S NAME. Ins. onlV.QIIinama(12aor 12b)
I
nNONE
OR 12b.INDIVIDUAL'SLASTNAME
FIRST NAME
MIDDLE NAME
SUFFIX
12c. MAIUNG ADDRESS
CITY
STATE ¡POSTAL CODE
COlA' TRY
13. thIs FINANCíNG STATEMENT covel&.U timbèr to bè out or 0 Ðs-èXtracted 16. Additiona oolaleral description:
collateral, or Is filed as a EJ lixture filing.
14. Desoription of real estate:
NW 1/4 SEC. 27 T-32N R-119W, LINCOLN COUNTY, WY
15. Neme and eddresa of a RECORD OWNER 01 """",,"des.ribed real ....tate
(ifDebtQr dOBS not ~all8 a reco!"Ø InteresO:
CHAD CAZIER
17. C~""k QD "applicable Bnd o~èCk QJJh( OnA box.
Debtor Is a rhTrust or n Trustee acting v,;1h respect to property held in trust or n Decedent's Estate
18. Check QD lfapplicable and o~èCkQJJh( one box.
Debtor 1& 1RANSMITTING lmUTY
Flied In ex nneolol1 wllh e Manulactured·Home frensaotion - e"èClive 30 years
Flied in ex nneotion wilh a Publlooflnanca Traneection - atIectiva 30yeara
FILING OFFICE COPY - UCC FINANCING STATEMENT ADDENDUM (FORM CC1Ad) (REV. OS/22/02)