HomeMy WebLinkAbout892218UCC FINANCING STATEMENT,
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
! A. NAME & PHONE OF CONTACT AT FILER (optional]
5880532
WYOM
FIXTURE
Phone:(800) 331-3282 Fax: (818) 662-4141
B. SEND ACKNOWLEDGEMENT TO: (Name and Address) 51 1615 ICOMMUNITY2
UCC Direct Services
P.O. Box 29071
Glendale, CA 91209-9071
8922
,RECEIVED
LI'NCOLN COUNTY CLERK
18
03 PH 1, 05
.JEANNE WAGNER
File with: Lincoln, WY
1. DEBTOR'S EXACT FULL LEGAL NAME - insert only on__c.e debtor name (la or lb) - do not abbreviate or combine names
I la. ORGANIZATION'S NAME
Kemmerer Antler Motel, LLC
OR
lb. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
' I SUFFIX
COUNTRY
lc. MAILING ADDRESS CITY
419 Coral Street Kemmerer
1 d. TAX ID #: SSN OR EIN FDD'L INFO RE le. ~rYPE OF ORGANIZATION lf. JURISDICTION OF ORGANIZATION
IORGANIZATION I Limited Liability Corporatio~ UT
83-0324214 ~DEBTOR
2. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only on_~.e debtor name (2a or 2b) - do not abbreviate or combine names
OR 2a. ORGANIZATION'S NAME
2b. INDIVIDUAL'S LAST NAME FIRST NAME
STATE I POSTAL CODE
WY 83101
lg. ORGANIZATIONAL ID #, il any
2056026-0160
E]NONF
MIDDLE NAME I SUFFIX
STATE POSTAL CODE [ COUNTRY
29. ORGANIZATIONAL ID #, if any
2c. MAILING ADDRESS
2d. TAX ID #: SSN OR EINFDD'LINFO RE
~RGANIZATION
~EBTOR
2e. TYPE OF ORGANIZATION
CITY
2f. JURISDICTION OF ORGANIZATION
3. SECURED PARTY'S NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR S/P) - insert only one secured pady name (3a or 3b)
3a. ORGANIZATION'S NAME --
Community First National Bank
OR
3b. INDIVIDUAL'S LAST NAME
ENONE~
FIRST NAME MIDDLE NAME I SUFFIX
CITY STATE POSTAL CODE COUNTRY
Salt Lake City I UT J84111
3c. MAILING ADDRESS
142 E. 200 South
4. This FINANCING STATEMENT covers the following collateral:
ALL FIXTURES AND IMPROVEMENTS NOW OWNED AND HEREAFTER ACQUIRED, INCLUDING REPLACEMENTS AND PROCEEDS THEREOF,
ALL RENTS, SUBRENTS, ISSUES, ROYALTIES. INCOME AND PROFITS. PARCEL 1: THE LOTS NUMBERED ONE (1). -rvvo (2). THREE.{3) AND
FOUR (4) OF THE BLOCK NUMBERED FIFTY-EIGHT (58) OF THE SECOND ADDITION TO THE TOWN OF KEMMERER. LINCOLN COUNTY.
WYOMING. PARCEL 2; LOT FOUR (4), FIVE (5), SiX (6), SEVEN (7), EIGHT (8), NINE (9), TEN (10) AND ELEVEN (11) OF THE BLOCK NUMBERED
SIXTY-FOUR (64) IN THE SECOND ADDITION IN THE TOWN OF KEMMERER, LINCOLN COUNTY, WYOMING. PROPERTY ADDRESS: 419 CORAL
STREET, KEMMERER, WYOMING 93101
.ALTERNAT,VEDES,GNAT,O. E]LESSE LE SOR EiOONS,GNE OO.S,G,OR FI"A'LE "^'LOR F--lSELLE"'""YER [] AG.L,EN E]NO..UOCF,L,N¢.
6.L-F~This FINANCING STATEMENT is t° be filed [f°r rec°rd] (°r recorded) in lhe REAL-, ESTATE RECORDS. Atlach Addendum [ii' aoolicablel I 7. Check to REQUEST SEARCH REPORT(S) on Debtor(s) E3Aii Debtors E~Debtor l~lDebtor 2
8. OPTIONAL FILER REFERENCE DATA I^DDITIONAL FEB loutional1
5880532 1100060 SBA 27/03
FILING OFFICE C, ' ONAL UCC FINANCING STATEMENT (FORM UCC' ;:!:i;i!i!!;!i;, 7/29/98)
..'i;~:;21;.;~;: Glendale, CA : ':: rel (800) 331-3282
Prepared by I ~ ~ vices, P.O. Box 29071,
FiNANCiNG STATEMENT ADDENDUM
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
9. NAME OF FIRST DEBTOR (ia or lb) ON RELATED FINANCING STATEMENT 9a. ORGANIZATION'S NAME
Kemmerer Antler Motel, LLC
OR FIRST MIDDLE
9b. INDIVIDUAL'S LAST NAME NAME NAME, SUFFIX
10. MISCELLANEOUS
5880532-40-1
511615 IcoMMUNITY2
1100060
SBA 27/03
File with: Lincoln, WY
575
THE ABOVE SPACE iS 'FOR FILING OFFICE uSE ONLY
11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only on___~e name (1 la or 1 lb) - do no( abbreviate or combine names
1 la. ORGANIZATION'S NAME
1 lb. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX
1 lc. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY
11d. TAXID#: SSNOREIN . ~ADD'L INFO RE [11e. TYPE OF ORGANIZATiON 11f. JURISDICTION OF ORGANIZATION 11g. ORGANIZATIONAL ID #, if any
~)RGANIZATION
EBTOR [] NON,
12. [] ADDiTiONAL SECURED i~ARTY,S or' [] ASSIGNORS/P's NAME - insert only on~e name (12a or12b) 12a. ORGANIZATION'S NAME
OR 12b. INDIVIDUAL'S LAST NAME FIRST NAME SUFFIX
MIDDLE NAME
ISTATE, POSTAL CODE
COUNTRY
~m
12c. MAILING ADDRESS Cll:~
16. Additional collateral description:
13. This FINANCING STATEMENT covers ~] timber to be cut or [] as-extracted
coliateral or is filed as a [] fixture filing.
14. Description of real estale:
Description: PARCEL 1: The Lots 1,2,3,and 4 of block 58
of the Second Addition to the Town of Kemmerer, Lincoln,
County, Wyoming. PARCEL 2: Lot 4, 5,6,7,8,9,10 and 11 of
block 64 in the Second Addition in the Town of Kemmerer,
Lincoln County, Wyoming.
15. Name and address of a RECORD OWNER of above-described real estate
(if Debtor does not have a record interest):
17. Check only if applicable and check only one box.
Debtor is' a~] Trust or [] Trustee acting with respect to properly held in Irust or [--'] Decedenrs Estate
18. Check only if applicable and check only one box.
"--]Debtor is a TRANSMI3q'ING UTILITY
E~] Filed in connectioh with a Manufactured-Home Transaction -- effective 30 years
[]Filed in connection with a Public-Finance Transaction -- e~ective 30 years
FILING OFFICE COPY - NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 07~29~98)
Prepared by UCC-Direct Services. Inc., P.O. Box 29071
Glendale. CA 91209-9071 Tel (800)331-3282