COURT STATE UCC OUNTY .OF. . .OF.SOUTH. DAKOTA. FINANCING.STATEMENT – . . . .3. . . . . Fee $_________________ ....... .. . . . .APPROVED STANDARD FORM. . . . . . . ..... ....... ... : AccountIndex No. Secretary of State # _____________ 500 E. Capitol Ÿ Pierre, SD 57501-5070 Ÿ 605-773-4422 : Calendar No. PLEASE TYPE THE INFORMATION ON THIS FORM ACCORDING TO ALL INSTRUCTIONS PRINTED ON THE BACK OF THE UCC 3 FORM NOTE: Type smaller than 8 point is not acceptable. This is an example of 8 point type. : 1. SECURED PARTY NAME AND ADDRESS insert only one secured party name (1a or 1b) Plaintiff(s) 1a. ORGANIZATION’S NAME or -against- JUDICIAL SUBPOENA FIRST NAME 1c. MAILING ADDRESS : MIDDLE NAME CITY 1b. INDIVIDUAL’S LAST NAME : STATE POSTAL CODE COUNTRY 2. ASSIGNEE OF SECURED PARTY NAME AND ADDRESS insert only one assignee name (2a or 2b) : 2a. ORGANIZATION’S NAME or 2b. INDIVIDUAL’S LAST NAME FIRST Defendant(s) NAME : . . . . . 2c..MAILING ADDRESS . . . . . . . . . . . . . . . . . . . . . . . . . . . . CITY. . . . . . . ......... .. MIDDLE NAME STATE SUFFIX POSTAL CODE COUNTRY 3. DEBTOR’S EXACT FULL LEGAL NAME – insert only one debtor (3a or 3b) – do not abbreviate or combine names. 3a. ORGANIZATION’S NAME or HE PEOPLEINDIVIDUAL’S LAST NAME OF NEW YORK 3b. OF THE STATE O SUFFIX FIRST NAME CITY 3c. MAILING ADDRESS ADD’S INFO RE ORGANIZATION DEBTOR 3d. TAX ID # SSN OR EIN MIDDLE NAME STATE 3e. TYPE OF ORGANIZATION SUFFIX POSTAL CODE 3f. JURISDICTION OF ORGANIZATION COUNTRY 3G. ORGANIZATIONAL ID#, if any o NONE 4. ADDITIONAL DEBTOR’S EXACT FULL LEGAL NAME – insert only one debtor name (4a or 4b) – do not abbreviate or combine names. 4a. ORGANIZATION’S NAME REETINGS: or 4b. INDIVIDUAL’S LAST NAME FIRST NAME MIDDLE NAME SUFFIX WE COMMAND YOU, that all business and excuses being laid aside, you and each of youPOSTAL CODE attend before 4c. MAILING ADDRESS CITY STATE COUNTRY , e Honorable at the Court ADD’S INFO RE 4d. TAX ID # SSN OR EIN 4e. TYPE OF ORGANIZATION 4f. JURISDICTION OF ORGANIZATION 4G. ORGANIZATIONAL ID#, if any ounty of ORGANIZATION located at o NONE DEBTOR room , on the day of , 20 , at o'clock in the noon, and at any recessed THIS STATEMENT REFERS adjourned date, to testify TO ORIGINALevidence STATEMENT NO._____________________________________________________________(limited to one transaction per UCC 3) and give FINANCING as a witness in this action on the part of the DATE___________________________________________________ FILED WITH_________________________________________________________________________________ o CONTINUATION The financing statement bearing the above file number is still effective. o TERMINATION The secured party no longer claims a security interest under the financing statement bearing the above file number. Must be signed by secured party for effective financing statements. o ASSIGNMENT The secured party’s rights to the property described below under the statement bearing the above file number have been assigned to the assignee whose name and address are listed abovet. Must be signed by secured party and debtor for Effective Financing Statement. o AMENDMENT The financing statement bearing the above file number is amended Your failure to comply with this subpoena is punishable as a contempt of court and will make you andas set forth below. Must Financing Statement. liable party for Effective be signed by both to debtor secured Cannot whose than six months prior to the filed e party on be date. more behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a expiration sult of your failure to comply. Fee: $20 and $2 for each additional debtor name Fee: $20 and $2 for each additional debtor name Fee: None Fee: $20 and $2 for each additional debtor name This area is for the description of collateral, release, collateral if assigned, or description of real estate, if necessary: Witness, Honorable ourt in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Check (X) if covered: o PROCEEDS of collateral are also covered. o PRODUCTS of collateral are also covered. Use the following spaces only for Farm Products requiring EFFECTIVE FINANCING STATEMENT (EFS) FARM PRODUCT CODE YEAR QUANTITY Attorney(s) for COUNTY CODE LOCATION IN COUNTY OR FURTHER DESCRIPTION Office and P.O. Address Pay proceeds to Debtor and Secured Party unless otherwise checked: o Secured Party only o Debtor only Filed with the Secretary of State as o UCC o EFS o BOTH Signature(s) of Debtor(s) Number of Telephone No.: Additional Sheets, if any_____________________________________ Facsimile No.: E-Mail Address: Mobile Tel. No.: Signature of Secured Party American LegalNet, Inc. www.USCourtForms.com UCC 3 FORM Revised 7/01/01