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3b. INDIVIDUAL'S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
3c. MAILING ADDRESS
P.O. Box 7000
CITY
Jackson
STATE
WY
POSTAL CODE
83002
COUNTRY
USA
UCC FINANCING STATEMENT
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
A. NAME PHONE OF CONTACT AT FILER [optional]
Rickie Turgeon 307 732 -3044
B. SEND ACKNOWLEDGMENT TO: (Name and Address)
L
Bank of Jackson Hole
Main Branch
P.O. Box 7000
Jackson, WY 83002
1
1. DEBTORS EXACT FULL LEGAL NAME insert only one debtor name (la or 1b) do not abbreviate or combine names
la. ORGANIZATION'S NAME
lb INDIVIDUAL'S LAST NAME
Simkins
MAILING ADDRESS
0. Box 224
SEE INSTRUCTIONS
ADD'L INFO RE 11e. TYPE OF ORGANIZATION
ORGANIZATION Individual
DEBTOR
FIRST NAME
Jody
CITY
Afton
1f. JURISDICTION OF ORGANIZATION
MIDDLE NAME
M.
STATE
WY
POSTAL CODE
83110
1g. ORGANIZATIONAL ID if any
OR
lc
P.
1 d.
2. ADDITIONAL DEBTOR S EXACT FULL LEGAL NAME insert only one debtor name (2a or 2b) do not abbreviate or combine names
2a. ORGANIZATION'S NAME
2b. INDIVIDUAL'S LAST NAME
Simkins AKA Kris H. Simkins
MAILING ADDRESS
0. Box 224
SEE INSTRUCTIONS
ADD'L INFO RE 12e. TYPE OF ORGANIZATION
ORGANIZATION Individual
DEBTOR
FIRST NAME
Kristine
CITY
Afton
2f. JURISDICTION OF ORGANIZATION
MIDDLE NAME
H.
STATE
WY
POSTAL CODE
83110
2g. ORGANIZATIONAL ID if any
E
OR
2c.
P.
2d.
3. SECURED PARTY'S NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR S /P) insert only one secured party name (3a or 3b)
3a. ORGANIZATION'S NAME
Bank of Jackson Hole
4. This FINANCING STATEMENT covers the following collateral:
All funiture, fixtures, inventory and equipment on the certain Real Property located at 970 South Washington, Afton, WY 83110, more
particulary described as Parcel 2: Lot 29 of the Airport Addition Fifth Filing to the Town of Afton, Lincoln County, Wyoming as described on
the official plat filed on March 26, 2007 as Instrument No. 927852 of the records of the Lincoln County Clerk; Parcel 3: Lot 30 of Airport
Addition Fifth Filing, Lincoln County, Wyoming as described on the official plat filed on March 26, 2007 as Instrument No. 927852 of the
records of the Lincoln County Clerk; Parcel 4: Lot 23 of Airport Addition Second Filing, Lincoln County, Wyoming as described on the official
plat filed on July 8, 2003 as Instrument No. 891430 of the records of the Lincoln County Clerk; Parcel 5: Beginning at the Northeast corner
of said South Half Southwest Quarter, found as described in that Certified Land Corner Recordation Certificate filed in said Office; thence
South 00 °04.1' West 453.30 feet, along the East line of said South Half Southwest Quarter to a point; thence North 89 °35.2' West 619.29
feet to a point; thence North 06 °00.0' East 450.22 feet to a point on the North line of said South Half Southwest Quarter; thence North
89 °53.3' East 572.76 feet, along said North line to the point of beginning; as described in Book 330 of Photostatic Records, on page 527, as
Document No. 766539 in said office. Less and excepting the following described tract of land: That part of the South Half Southwest
Quarter of Section 31, Township 32 North, Range 118 West, Lincoln County, Wyoming, describedas follows: Beginning at the Northeast
corner of said South Half Southwest Quarter, found as described the Certified Land Corner Recordation Certificate filed in said Office; thence
South 00 °04.1' West 265.30 feet, along the East line of said South Half Southwest Quarter to a point; thence North 89 °35.2' West 599.77
feet to a point; thence North 06 °00.0' East 261.33 feet to a point on the North line of said South Half Southwest Quarter; thence North
89 °53.3' East 572.76 feet along said North line to the point of beginning. As described in Book 330 of Photostatic Records, on Page 537 as
(Continued on attached Financing Statement Addendum)
5. ALTERNATIVE DESIGNATION if applicable). n LESSEE /LESSOR n CONSIGNEE/CONSIGNOR 1 1 BAILEE /BAILOR 1 I SELLER /BUYER J 1 AG. LIEN I 1 NON -UCC FILING
6. Fl/ This FINANCING STATEMENT is to be filed [for record] (or recorded) in the REAL 7. Check to REQUEST SEARCH REPORT(S) on Debtor(s) u
ESTATE RECORDS. Attach Addendum fif applicable) [ADDITIONAL FEE) [optional) All Debtors Debtor 1 Iu' Debtor 2
8. OPTIONAL FILER REFERENCE DATA
FILING OFFICE COPY UCC FINANCING STATEMENT (FORM UCC1) (REV. 05/22/02)
RECEIVED 3/10/2011 at 10:29 AM
RECEIVING 958416
BOOK: 763 PAGE: 511
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
000511
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
SUFFIX
COUNTRY
SUFFIX
COUNTRY
NONE
NONE
Harland Financial Solutions
400 S.W. 6th Avenue, Portland, Oregon 97204
OR
11b. INDIVIDUAL'S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
110. MAILING ADDRESS
P.O. Box 1218
CITY
Afton
STATE
WY
POSTAL CODE
83110
COUNTRY
11d.
SEE INSTRUCTIONS
ADD'L INFO RE 111e. TYPE OF ORGANIZATION
ORGANIZATION
DEBTOR 1 Trust
11f. JURISDICTION OF ORGANIZATION
WY
11g. ORGANIZATIONAL ID if any
NONE
12.
OR
1 ADDITIONAL SECURED PARTY'S or I I ASSIGNOR S /P'S NAME insert only one name (12aor12b)
12a. ORGANIZATION'S NAME
12b. INDIVIDUALS LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
12c,
MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
13. This FINANCING STATEMENT covers timber to be cut or as- extracted
collateral, or is filed as a fixture filing.
14. Description of real estate:
Parcel 2:
Lot 29 of the Airport Addition Fifth Filing to the Town of
Afton, Lincoln County, Wyoming as described on the official
plat filed on March 26, 2007 as Instrument No. 927852 of
the records of the Lincoln County Clerk
Parcel 3:
Lot 30 of Airport Addition Fifth Filing, Lincoln County,
Wyoming as described on the official plat filed on March 26,
2007 as Instrument No. 927852 of the records of the
Lincoln County Clerk
Parcel 4:
Lot 23 of Airport Addition Second Filing, Lincoln County,
Wyoming as described on the official plat filed on July 8,
15. Name and address of a RECORD OWNER of above described real estate (if
Debtor does not have a record interest):
16. Additional collateral description:
Document No. 766543 in said office.Whether any of the foregoing is owned
now or acquired later; all accessions, replacements, and substitutions
relating to any of the foregoing; all records of any kind relating to any of hte
foregoing; all proceeds relating to any of the foregoing (including insurance,
general intangibles and other accounts proceeds).
17. Check only if applicable and check only one box.
Debtor is a n Trust or n Trustee acting with respect to property held in trust or n Decedent's Estate
18
R Debtor
Check only if applicable and check only one box.
is a TRANSMITTING UTILITY
Filed in connection with a Manufactured -Home Transaction
Filed in connection with a Public- Finance Transaction
NAME OF FIRST DEBTOR (la or 1b) ON RELATED FINANCING STATEMENT
9a. ORGANIZATION'S NAME
9b. INDIVIDUALS LAST NAME
Simkins
MISCELLANEOUS:
FIRST NAME
Jody
MIDDLE NAME, SUFFIX
M.
UCC FINANCING STATEMENTADDENDUM
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
9,
OR
10.
11. ADDITIONAL DEBTORS EXACT FULL LEGAL NAME insert only one name (115 or 11 b) do not abbreviate or combine names
11a. ORGANIZATION'S NAME
Gale L. and Shirley R. Haderlie Family Trust dated December 28, 1999
FILING OFFICE COPY UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 05/21/09)
000512
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
400 S.W. 6th Avenue, Portland, Oregon 97204
O R
11 b. INDIVIDUALS LAST NAME
Simkins
FIRST NAME
Travis
MIDDLE NAME
J.
SUFFIX
11c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
11d. SEE INSTRUCTIONS
ADD'L INFO RE 111e. TYPE OF ORGANIZATION
11f. JURISDICTION OF ORGANIZATION
11g. ORGANIZATIONAL ID if any
ORGANIZATION Individual
DEBTOR NONE
127
ADDITIONAL SECURED PARTY'S or ASSIGNOR S /P'S NAME insert only one name (12a or 12b)
12a. ORGANIZATIONS NAME
OR
12b. INDIVIDUALS LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
12c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
13. This FINANCING STATEMENT covers timber to be cut or as- extracted
collateral, or is filed as a fixture filing.
14. Description of real estate:
2003 as Instrument No. 891430 of the records of the
Lincoln County Clerk
Parcel 5:
That part of the South Half Southwest Quarter of Section
31, Township 32 North, Range 118 West, Lincoln County,
Wyoming, being part of that tract of record in the Office of
the Clerk of Lincoln County in Book 194 of Photostastic
records on Page 654, described as follows: Beginning at the
Northeast corner of said South Half Southwest Quarter,
found as described in that Certified Land Corner Recordation
Certificate filed in said Office; thence South 00 °04.1' West
453.30 feet, along the East line of said South Half
Southwest Quarter to a point; thence North 89 35.2' West
619.29 feet to a point; thence North 06 °00.0' East 450.22
15. Name and address of a RECORD OWNER of above described real estate (if
Debtor does not have a record interest):
16. Additional collateral description:
17. Check only if applicable and check only one box.
Debtor is a n Trust or n Trustee acting with respect to property held in trust or n Decedents Estate
18
R Debtor
II Filed
Check only if applicable and check only one box.
is a TRANSMITTING UTILITY
Filed in connection with a Manufactured -Home Transaction
in connection with a Public- Finance Transaction
NAME OF FIRST DEBTOR (la or lb) ON RELATED FINANCING STATEMENT
9a. ORGANIZATIONS NAME
9b. INDIVIDUALS LAST NAME
Simkins
MISCELLANEOUS:
FIRST NAME
Jody
MIDDLE NAME, SUFFIX
M.
UCC FINANCING STATEMENTADDENDUM
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
9.
OR
10.
11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME insert only one name (11a or 1lb) do not abbreviate or combine names
11a. ORGANIZATIONS NAME
FILING OFFICE COPY UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 05/21/09)
0
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
400 S.W. 6th Avenue, Portland, Oregon 97204
UK
11b. INDIVIDUAL'S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
11c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
11d.
SEE INSTRUCTIONS
ADD'L INFO RE 111e. TYPE OF ORGANIZATION
ORGANIZATION
11f. JURISDICTION OF ORGANIZATION
11g. ORGANIZATIONAL ID if any
ONE
I INONE
[I
12.
OR
1 ADDITIONAL SECURED PARTY'S or I I ASSIGNOR S /P'S NAME insert only one name (12aor12b)
12a. ORGANIZATION'S NAME
12b. INDIVIDUALS LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
12c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
13. This FINANCING STATEMENT covers timber to be cut or as- extracted
collateral, or is filed as a fixture filing.
14. Description of real estate:
feet to a point on the North line of said South Half
Southwest Quarter; thence North 89 °53.3' East 572.76
feet, along said North line to the point of beginning; as
described in Book 330 of Photostatic Records, on page 527,
as Document No. 766539 in said office.
Less and excepting the following described tract of land:
That part of the South Half Southwest Quarter of Section
31, Township 32 North, Range 118 West, Lincoln County,
Wyoming, describedas follows: Beginning at the Northeast
corner of said South Half Southwest Quarter, found as
described the Certified Land Corner Recordation Certificate
filed in said Office; thence South 00 °04.1' West 265.30
feet, along the East line of said South Half Southwest
Quarter to a point; thence North 89 °35.2' West 599.77 feet
15. Name and address of a RECORD OWNER of above- described real estate (if
Debtor does not have a record interest):
16. Additional collateral description:
17. Check only if applicable and check only one box.
Debtor is a n Trust or n Trustee acting with respect to property held in trust or n Decedent's Estate
18
R Debtor
Check only if applicable and check only one box.
is a TRANSMITTING UTILITY
Filed in connection with a Manufactured -Home Transaction
Filed in connection with a Public- Finance Transaction
UCC FINANCING STATEMENTADDENDUM
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
NAME OF FIRST DEBTOR (la or 1b) ON RELATED FINANCING STATEMENT
9a. ORGANIZATION'S NAME
9b. INDIVIDUAL'S LAST NAME
Simkins
MISCELLANEOUS:
FIRST NAME
Jody
MIDDLE NAME, SUFFIX
M.
9.
OR
10.
11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME insert only one name (11a or 11 b) do not abbreviate or combine names
11a. ORGANIZATION'S NAME
FILING OFFICE COPY UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 05/21/09)
arlan Financia So
000514
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
400 S.W. 6th Avenue, Portland, Oregon 97204
OR
11b. INDIVIDUALS LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
11c.
MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
11d.
SEE INSTRUCTIONS
ADD'L INFO RE 111e. TYPE OF ORGANIZATION
ORGANIZATION
DEBTOR
11f. JURISDICTION OF ORGANIZATION
11g. ORGANIZATIONAL ID if any
NONE
12.1
OR
ADDITIONAL SECURED
PARTY'S or 1 1 ASSIGNOR S /P'S NAME insert only one name (12a or 12b)
12a. ORGANIZATION'S NAME
12b. INDIVIDUALS LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
12c.
MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
13. This FINANCING STATEMENT covers timber to be cut or as- extracted
collateral, or is filed as a fixture filing.
14. Description of real estate:
to a point; thence North 06 °00.0' East 261.33 feet to a
point on the North line of said South Half Southwest
Quarter; thence North 89 °53.3' East 572.76 feet along said
North line to the point of beginning.
As described in Book 330 of Photostatic Records, on Page
537 as Document No. 766543 in said office.
15. Name and address of a RECORD OWNER of above described real estate (if
Debtor does not have a record interest):
16. Additional collateral description:
17. Check only if applicable and check only one box.
Debtor is a n Trust or n Trustee acting with respect to property held in trust or n Decedents Estate
18.
Check only if applicable and check only one box.
Debtor is a TRANSMITTING UTILITY
Filed in connection with a Manufactured -Home Transaction
Filed in connection with a Public- Finance Transaction
u .1nr1 Pinanria1 Snllltinnq
NAME OF FIRST DEBTOR (la or 1b) ON RELATED FINANCING STATEMENT
9a. ORGANIZATION'S NAME
9b. INDIVIDUALS LAST NAME
Simkins
MISCELLANEOUS:
FIRST NAME
Jody
MIDDLE NAME, SUFFIX
M.
UCC FINANCING STATEMENTADDENDUM
FOLLOW INSTRUCTIONS (front and back CAREFULLY
9.
OR
10.
11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME insert only one name (11a or 11 b) do not abbreviate or combine names
11a ORGANIZATION'S NAME
FILING OFFICE COPY UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 05/21/09)
000515
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
400 S.W. 6th Avenue, Portland, Oregon 97204