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7a. ORGANIZATION'S NAME
713. INDIVIDUAL'S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
7c. MAILING ADDRESS
PO BOX 224
CITY
AFTON
STATE
WY
POSTAL CODE
83110
COUNTRY
USA
7d. TAX ID SSN OR EIN
ADD L INFO RE 17e. TYPE OF ORGANIZATION
ORGANIZATION
DEBTOR 1 INDIVIDUAL
7f. JURISDICTION OF ORGANIZATION
7g. ORGANIZATIONAL ID if any
X NONE
UCC FINANCING STATEMENTAMENDMENT
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
A. NAME PHONE OF CONTACT AT FILER fontionall
GERRI KITTRELL
B. SEND ACKNOWLEDGMENT TO: (Name and Address)
I BANK OF JACKSON HOLE
MAIN BRANCH
PO BOX 7000
JACKSON WY 83002
L
la. INITIAL FINANCING STATEMENT FILE
#944168 BK: 711 PG: 137
RECEIV
REC
BOOK:
LINCOLN C
THE ABOVE SPAC
2. TERMINATION: Effectiveness of the Financing Statement identified above is lerminaled with respect to security interest(s) of the Se
3. CONTINUATION: Effectiveness of the Financing Statement identified above with respect to security interest(s) of the Secured Party aulhonzing this Continuation Statement is
continued for the additional period provided by applicable law.
4. {ASSIGNMENT (full or partial): Give name of assignee in item 7a or 7b and address of assignee in item 7c; and also give name of assignor m item 9
5. AMENDMENT (PARTY INFORMATION): This Amendment affects ❑Debtor or ❑Secured Party of record. Check only one of these two boxes.
Also check one of the following three boxes provide appropriate Information in items 6 and /or 7.
CHANGE name and /or address: Give current record name in item 6a or 6b; also give new 0 DELETE name: Give record name ADD name. Complete item 7a or 7b, and also
name (if name change) in item 7a or 7b and /or new address (if address change) in item 7c to be deleted in item 6a or 6b. item 7c; also complete items 7d -7q (if applicable).
6. CURRENT RECORD INFORMATION:
OR
OR
6a. ORGANIZATION'S NAME
6b. INDIVIDUAL'S LAST NAME
SIMKINS
7. CHANGED (NEW) OR ADDED INFORMATION:
8. AMENDMENT (COLLATERAL CHANGE): check only one box.
Describe collateral ❑deleted or added, or give entirerestated collateral description. or describe collateral ❑assigned
9. NAME OF SECURED PARTY OF RECORD AUTHORIZING THIS AMENDMENT (name of assignor, if this is an Assignment). If this is an Amendment authorized by a Debtor which
adds collateral or adds the authorizing Debtor, or if this is a Termination authorized by a Debtor. check here and enter name of DEBTOR authorizing this Amendment.
9a. ORGANIZATION'S NAME BANK OF JACKSON HOLE
9b. INDIVIDUAL'S LAST NAME
10.OPTIONAL FILER REFERENCE DATA
FIRST NAME
JODY
FIRST NAME
FILING OFFICE COPY NATIONAL UCC FINANCING STATEMENT AMENDMENT (FORM UCC3) (REV. 07/29/98)
ED 4/22/2011 at 10:44 AM
EIVING 959002
765 PAGE: 681
JEANNE WAGNER
OUNTY CLERK, KEMMERER, WY
E IS FOR FILING OFFICE USE ONLY
lb. This FINANCING STATEMENT AMENDMENT is
to be filed (tor record) (or recorded) in the
REAL ESTATE RECORDS.
cured Party authorizing this Termination Statement
MIDDLE NAME
M
MIDDLE NAME
000681
SUFFIX
SUFFIX
UCC FINANCING STATEMENTAMENDMENT ADDENDUM
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
11
#9
INITIAL FINANCING STATEMENT FILE 9 (same as item to on Amendment form)
44168 BK: 711 PG: 137
NAME OF PARTY AUTHORIZING THIS AMENDMENT (same as item 9 on Amendment form)
12a. ORGANIZATION'S NAME
BANK OF JACKSON HOLE
12b. INDIVIDUAL'S LAST NAME
Use this space for additional information
FIRST NAME
MIDDLE NAME,SUFFIX
12.
OR
13.
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
FILING OFFICE COPY NATIONAL UCC FINANCING STATEMENT AMENDMENT ADDENDUM (FORM UCC3Ad) (REV. 07/29/98)
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