HomeMy WebLinkAbout887423UCC FINANCING STATEMENT
FOLLOW INSTRUCTIONS /front and back/ CAREFULLY
A. NAME & PHONE OF CONTACT AT FILER [oplional]
B. SEND ACKNOWLEDGEMENT TO: (Name and Address)
I LexisNexis Document Solutions
P. O. Box 2969
Springfield, Illinois 62708
RECEIVED
LINCOLN 00_I,',ITY CLERK
BOOK' ll _PR P^O 7 0 8
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
· DE BTOR'S EXACT FULL LEGAL NAME - insert only one debtor name (la or lb) - do not abbreviate or combine names
ORGANIZATION'S NAME
I lb. INDIVIDUAL'S LAST NAME
I Hruska FIRST NAME
OR
Randal .
lc. MAILING ADDRESS CITY [STATE I POSTAL CODE
599 Fairview Road J Fairview / WY I 83119
l d. TAX ID #; SSN OR LIN I ADO'L ~NFO RE I~e. TYPE oF ORGANIZATION ilf JURISDICTION OF ORGANIZATION /lg ORGANIZATIONAL ID # if any
I ORGANIZATION .....
473-52-0215 ~ Inalv aual [ 1
2. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert onl_y once debtor name (2a or 2b) - do not abbrewate or combine names
t2a ORGANIZATION'S NAME
OR 2b. INDIVIDUAL'S LAST NAME
Hruska
ISUFFIX
COUNTRY
USA
FIRST NAME
Pamela
2c. MAILING ADDRESS CITY
599 Fairview Road Fairvlew
2d, TAX ID #: SSN OR LIN I ADD'L INFO RE ] 2e. TYPE OF ORGANIZATION 2f. JURISDICTION OF ORGANIZATION
~ ORGANIZATION
264-04--4095 L~EBTOR LIndividual j_.
3. SECURED PARTY'S NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR SIP.) - insert only once secured party name (3a or 3b)
MIDDLE NAME
STATE I POSTAL CODE
2ge' %RGA~N~Z%1TI1OgNAL O 8, if any
SUFFIX
COUNTRY
USA
3a. ORGANIZATION'S NAME
National Cooperative Bank
/3b. INDIVIDUAL'S LAST NAME
IFIRST NAME MIDDLE NAME I SUFFix
c,~' ISTATE IPOSTAL CODE
I COUNTRY
3c. MAILING ADDRESS
1725 Eye Street, N.W. SMile 600
4. This FINANCING STATEMENT covers the followingcollateral:
All Fixtures; whether any of the foregoing is owned now or acquired later; all accessions, additions, replacements, and subslilutions
relating !0 any of lhe foregoing; all records of any kind relaling to any of the foregoing; all proceeds relaling to any of the foregoing
(including insurance, general Inlangibles and accounts proceeds). That part of Section 9, T31N R119W of the 6th P.M. Lincoln County,
Wyoming more particularly described as follows: COMMENCING at a point 30 rods West from the Northeast corner of SE1/4NEI/4 in said
Section 9and running thence Soulh 16 rods; lhence West 15 rods; thence North 16 rods; thence Easl 15 rods to the Poinl of Beginning.
Property Iocaled at 599 Fairview Road, Fairview, WY 83119, LINCOLN COUNTY.
8. OPTIONAL FILER REFERENCE DATA
Harland Financial Solutions
FILING OFFICE COPY -- NATIONAL UCC FINANCING STATEMENT (FORM UCC1) (REV. 07/29/98) 400 S.W. 6th Avenue, Portland, Oregon 97204