UNIFORM COMMERCIAL CODE FINANCING STATEMENT STANDARD UCC-1/CNS-1 NORTH DAKOTA SECRETARY OF STATE/COUNTY RECORDERS SFN 14009 (09-27-01) PLEASE TYPE. Please read instructions on back before completing. A. File In UCC Index Farm Products Central Notice (CNS) B. Customer Billing Number D. Transmitting Utility C. Submitted By Facsimile FAX # E. Debtor's Exact Full Legal Name - do not abbreviate or combine names If individual Last Name First Individual Organization SSN or TIN 1. ___________________________________________________ ____________________________ ADDRESS: __________________________________________________________________________ ADD'L INFO RE ORGANIZATION DEBTOR TYPE OF ORGANIZATION Individual JURISDICTION OF ORGANIZATION ORGANIZATIONAL ID #, if any Organization NONE 2. _______________________________________________________ ________________________ ADDRESS: __________________________________________________________________________ ADD'L INFO RE ORGANIZATION DEBTOR TYPE OF ORGANIZATION JURISDICTION OF ORGANIZATION NONE F. SECURED PARTY NAME AND ADDRESS (from which security info is obtainable) SSN/TIN: Telephone # H. Check If Covered: Reserved for Filing Officer Use ORGANIZATIONAL ID #, if any G. ASSIGNEE NAME AND ADDRESS (if any) SSN/TIN: Telephone # I. This financing statement covers the following collateral: (If filing in Farm Products Central Notice, include a reasonable description of the property, including the county in which the property is located.) PROCEEDS PRODUCTS FARM PRODUCTS CENTRAL NOTICE CNS-1 This FARM PRODUCT Central Notice filing is presented to the filing officer pursuant to NDCC 41-09-40. Signature of Debtor and Secured Party required. J. COUNTY CODE FARM PRODUCT CODE DESCRIPTION (if applicable) CROP YEAR (if applicable) QUANTITY (if applicable) COUNTY CODE 1. CROP YEAR (if applicable) QUANTITY (if applicable) 4. 5. DESCRIPTION (if applicable) 2. 3. FARM PRODUCT CODE 6. K. Debtor Signature _____________________________________________________________________________________________________________ By _________________________________________ By ____________________________________________ Name & Title Name & Title By _____________________________________________ Name & Title Secured Party Signature ____________________________________________________________ By_____________________________________________ Name & Title RETURN ACKNOWLEDGEMENT COPY TO: (name and address) American LegalNet, Inc. www.FormsWorkflow.com Please do not type outside of bracketed area UNIFORM COMMERCIAL CODE FINANCING STATEMENT STANDARD UCC-1/CNS-1 NORTH DAKOTA SECRETARY OF STATE/COUNTY RECORDERS SFN 14009 (09-27-01) PLEASE TYPE. Please read instructions on back before completing. A. File In UCC Index Farm Products Central Notice (CNS) B. Customer Billing Number D. Transmitting Utility C. Submitted By Facsimile FAX # E. Debtor's Exact Full Legal Name - do not abbreviate or combine names If individual Last Name First Individual Organization SSN or TIN 1. ___________________________________________________ ____________________________ ADDRESS: __________________________________________________________________________ ADD'L INFO RE ORGANIZATION DEBTOR TYPE OF ORGANIZATION Individual JURISDICTION OF ORGANIZATION ORGANIZATIONAL ID #, if any Organization NONE 2. _______________________________________________________ ________________________ ADDRESS: __________________________________________________________________________ ADD'L INFO RE ORGANIZATION DEBTOR TYPE OF ORGANIZATION JURISDICTION OF ORGANIZATION NONE F. SECURED PARTY NAME AND ADDRESS (from which security info is obtainable) SSN/TIN: Telephone # H. Check If Covered: Reserved for Filing Officer Use ORGANIZATIONAL ID #, if any G. ASSIGNEE NAME AND ADDRESS (if any) SSN/TIN: Telephone # I. This financing statement covers the following collateral: (If filing in Farm Products Central Notice, include a reasonable description of the property, including the county in which the property is located.) PROCEEDS PRODUCTS FARM PRODUCTS CENTRAL NOTICE CNS-1 This FARM PRODUCT Central Notice filing is presented to the filing officer pursuant to NDCC 41-09-40. Signature of Debtor and Secured Party required. J. COUNTY CODE FARM PRODUCT CODE DESCRIPTION (if applicable) CROP YEAR (if applicable) QUANTITY (if applicable) COUNTY CODE 1. CROP YEAR (if applicable) QUANTITY (if applicable) 4. 5. DESCRIPTION (if applicable) 2. 3. FARM PRODUCT CODE 6. K. Debtor Signature _____________________________________________________________________________________________________________ By _________________________________________ By ____________________________________________ Name & Title Name & Title By _____________________________________________ Name & Title Secured Party Signature ____________________________________________________________ By_____________________________________________ Name & Title RETURN ACKNOWLEDGEMENT COPY TO: (name and address) Acknowledgment Copy Please do not type outside of bracketed area American LegalNet, Inc. www.FormsWorkflow.com SFN 14009 (09-27-01) 1. 2. 3. 4. UCC-1/CNS-1 INSTRUCTIONS If the space provided for any item on this form is inadequate use UCC-5/CNS-5 form as an attachment. Verify for accuracy and correct spelling. Submit the original and one copy to any County Recorders' office or the Secretary of State's office. Refer to the user's guide for further information. The guide may be purchased from the Secretary of State's office. The following letters correspond to the lettered sections on the front of this form. You may use this form to file in either the UCC Index or CNS Index or both. If neither box is marked, the filing will be considered a A. UCC filing only. B. CUSTOMER BILLING #: Clients may request to be billed for services. Upon approval a customer billing number is provided. This number needs to be typed on the form for accurate billing processing. C. Check if applicable. Be sure to include your fax number if submitting by fax. D. Check if the debtor is a transmitting utility. E. DEBTOR NAME: Individual or Oranization - Check one per debtor. If an individual, enter last name, first name and middle name. For a business, begin with the first word or character not an article or punctuation mark. Provide a complete mailing address for all debtors. Social Security Number (SSN) or Tax Identification Number (TIN) must be provided for each debtor. If debtor is an organization the additional information must be provided: type of organization, jurisdiction of organization, and organizational ID number (if any) or check none. F. SECURED PARTY NAME: Enter the name of all secured parties and an address and telephone number from which security information is obtainable. SSN/TIN number for each secured party is optional. G. ASSIGNEE NAME: Follow same instructions as with "F". H. PROCEEDS, PRODUCTS: If proceeds and/or products are to be covered, indicate by marking an "X". I. DESCRIBE THE COLLATERAL. A description of collateral is necessary for filing. If collateral is filed in Farm Products Central Notice, include a reasonable description of the property, including the county in which the property is located. J. FARM PRODUCTS: List the county code from the list below for the county where produced. List the appropriate farm product code from the list below. A more specific description of the farm product may be entered. If "crop year" and/or "quantity" are left blank, the default will be "ALL". Each farm product must be listed separately. K. SIGNATURES: ALL DEBTORS AND SECURED PARTIES ARE REQUIRED TO SIGN THE CNS-1 PORTION FOR FILING IN CENTRAL NOTICE INDEX. RETURN ACKNOWLEDGEMENT COPY: Complete to whom acknowledgement copy should be sent. 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Wheat/Durum Rye Barley Corn Oats Sorghum Buckwheat Triticale Flax Soybeans Sunflowers Safflowers Mustard Millet Rape Seed Potatoes Beans Peas Sugar Beets Hay/Alfalfa Grasses Clover Wool Eggs Milk PRODUCT CODES 26 Cheese/Whey 27 Cream 28 Lentils 29 Honey 30 Bees Wax 31 Berries 32 Fruits 33 Trees/Shrubs 34 Herbs 35 Garlic 36 Popcorn 37 Canola 38 Crambe 39 Pellets 40 Fourage 41 Silage 42 Speltz 43 Sunwheat 44 Onions 45 Carrots 46 Squash 47 Vegetables 48 Pumpkins 49 Borage 50 Chick Peas 51 Amaranth 52 Mint 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 Cattle/Calves Beefalo Buffalo Hogs Sheep/Lambs Horses Mules Chickens Ducks Geese Turkeys Bees Goats Fox Furs/Pelts Fish Pheasants Game Hens Llamas Elk Ostriches Rabbits Emus Rhea Bird Deer Bull Semen Dogs Worms 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 COUNTY CODES Adams 28 Barnes 29 Benson 30 Billings 31 Bottineau 32 Bowman 33 Burke 34 Burleigh 35 Cass 36 Cavalier 37 Dickey 38 Divide 39 Dunn 40 Eddy 41 Emmons 42 Foster 43 Golden Valley 44 Grand Forks 45 Grant 46 Griggs 47 Hettinger 48 Kidder 49 LaMoure 50 Logan 51 McHenry 52 McIntosh 53 McKenzie 54 McLean Mercer Morton Mountrail Nelson Oliver Pembina Pierce Ramsey Ransom Renville Richland Rolette Sargent Sheridan Sioux Slope Stark Steele Stutsman Towner Traill Walsh Ward Wells Williams Out of State FEES: See user's guide for further explanation of fees. 1. Filing both UCC-1 and CNS-1/Termination 2. Filing only UCC-1 Portion/Termination 3. Filing only CNS-1 Portion/Termination $15.00 $15.00 $15.00 4. Non-Standard Filing/Termination 5. Additional Attachments Per Typed Page (8 1/2 X 11) $20.00 $ 1.00 American LegalNet, Inc. www.FormsWorkflow.com