Free EFS 1 - Nebraska

Nebraska Effective Financing Statement
This form must be typed. Illegible forms will be returned without filing.
2. ADDITIONAL DEBTOR - IF INDIVIDUAL Name (Last, First, MI) Mailing Address State Zip Code City State Zip Code 1. DEBTOR - IF INDIVIDUAL Name (Last, First, MI) Mailing Address City

EFS - 1

FOR SECRETARY OF STATE USE ONLY

Soc. Sec. No. or Fed. Tax I.D. No. 3. ADDITIONAL DEBTOR - IF INDIVIDUAL Name (Last, First, MI) Mailing Address City State Zip Code

Soc. Sec. No. or Fed. Tax I.D. No. 4. ADDITIONAL DEBTOR - IF ENTITY Name Mailing Address City State Zip Code

FILING FEE $10.00
5. SECURED PARTY Name (Last, First) Mailing Address City State Zip Code

Soc. Sec. No. or Fed. Tax I.D. No.

Soc. Sec. No. or Fed. Tax I.D. No.

Soc. Sec. No. or Fed. Tax I.D. No.

6. PRODUCTS SUBJECT TO SECURITY INTERESTS (see Instructions) A separate line must be used for each product, year and county. The secured party has a security interest in the following farm products and proceeds of the Debtor. PRODUCT
CODE

NAME

CROP YEAR

COUNTY
CODE

NAME

PRODUCT DESCRIPTION WHEN LESS THAN ALL OF PRODUCT IS COVERED BY SECURITY INTEREST.

All amounts/quantities to the secured party's security interest; unless a specific crop year is indicated, this Statement is applicable for every crop year for the duration of this statement and any continuation thereof.


Signature(s) of Debtor(s) below:

Signature of Secured Party below:
By To be filed with: Nebraska Secretary of State UCC Division PO Box 95104 Lincoln, NE 68509

Reset Form
Revised by the Secretary of State, 4-99

IMPORTANT This statement must be typed. Illegible statements will be returned without filing. Precision in spelling, typing, numbers, and exact designation of names is imperative.

INSTRUCTIONS
Blocks 1-4, DEBTOR. ("Debtor" includes any person subjecting a farm product to a security interest.) NAME: a) Names of individual debtors must be entered one per line. Names of individuals must be entered with the surname (last name) first, followed by the individual's first name and middle initial or name, if any. Corporate names or other entities not a natural person must begin with the first word or character of the name not an article or punctuation mark.

b)

SOCIAL SECURITY NUMBER OR FEDERAL TAX IDENTIFICATION NUMBER. a) b) For each individual debtor named, the Social Security number must be entered. For each corporation, partnership or other entity debtor named which has ben assigned an IRS Taxpayer identification number (Fed Tax ID #), the Fed Tax ID # must be entered.

DEBTOR ADDRESS. The address of each debtor must be entered. At least a city, state, and zip code must be entered. BLOCK 5, SECURED PARTY. Name and address must be entered. The Federal Identification Number or social security number is optional. BLOCK 6, PRODUCTS SUBJECT TO SECURITY INTEREST. PRODUCT CODE: The three-digit product code of each farm product covered by the EFS-1 must be entered in the Product Code column. The table of product codes appears below. PRODUCT NAME: Enter the product name in the Product Name column. CROP YEAR: No entry is required if all crop years of the farm product are covered by the EFS-1. If fewer than all crop years are covered, the last two digits of each covered crop year must be entered. COUNTY CODE: The two-digit county code for each county in which the particular farm product is produced must be entered in the County Code column. The table of county codes appears below. PRODUCT DESCRIPTION: If not all of the product of the debtor is covered by the security interest, then insert amount covered. For example, if security interest is on 10,000 bushels of corn, you might choose to insert 10,000 bushels. WHO MUST SIGN: Must be signed by Debtor and Secured Party. A corporation must sign by an authorized officer. A partnership must sign by a general partner. WHERE TO FILE: Nebraska Secretary of State's Office, Business Services Division (UCC), PO Box 95104, Lincoln, NE 68509. ATTACHMENTS: If more space is required for additional debtors (Block 1-4) or products (Block 6), call the Secretary of State's Office at (402) 471-4 080 and ask for an EFS-A form.

PRODUCT CODE TABLE
101 Corn 102 Wheat 103 Sorghum Grain 104 Soybeans 105 Oats 106 Barley 107 Rye 108 Dry Beans 109 Popcorn 110 Flax Seed 111 Potatoes 112 Sugar Beets 113 Sunflower Seeds 114 Triticale 115 Vetch 116 Seed Crops 117 Silage 118 Hay 119 Millet 120 Safflower 201 Cattle & Calves 202 Hogs 203 Sheep & Lambs 204 Horses 205 Chickens 206 Turkeys 207 Fish 209 Eggs 210 Honey 211 Milk 212 Wool 213 Bees 214 Ostrich 215 Emu 216 Llama 217 Buffalo 218 Bull Semen 219 Embryos/Genetic Products ** 301 Apples 302 Artichokes 303 Asparagus 304 Cantaloupe 305 Carrots 306 Cucumbers 307 Grapes 308 Honey Dew Melon 309 Muskmelon 310 Onions 311 Pumpkins 312 Raspberries 313 Squash 314 Strawberries 315 Sweet Corn 316 Tomatoes 317 Trees 318 Walnuts 319 Watermelon 01 Douglas 02 Lancaster 03 Gage 04 Custer 05 Dodge 06 Saunders 07 Madison 08 Hall 09 Buffalo 10 Platte 11 Otoe 12 Knox 13 Cedar 14 Adams 15 Lincoln 16 Seward 17 York 18 Dawson 19 Richardson

COUNTY CODE TABLE
20 Cass 21 Scotts Bluff 22 Saline 23 Boone 24 Cuming 25 Butler 26 Antelope 27 Wayne 28 Hamilton 29 Washington 30 Clay 31 Burt 32 Thayer 33 Jefferson 34 Fillmore 35 Dixon 36 Holt 37 Phelps 38 Furnas 39 Cheyenne 40 Pierce 41 Polk 42 Nuckolls 43 Colfax 44 Nemaha 45 Webster 46 Merrick 47 Valley 48 Red Willow 49 Howard 50 Franklin 51 Harlan 52 Kearney 53 Stanton 54 Pawnee 55 Thurston 56 Sherman 57 Johnson 58 Nance 59 Sarpy 60 Frontier 61 Sheridan 62 Greeley 63 Boyd 64 Morrill 65 Box Butte 66 Cherry 67 Hitchcock 68 Keith 69 Dawes 70 Dakota 71 Kimball 72 Chase 73 Gosper 74 Perkins 75 Brown 76 Dundy 77 Garden 78 Deuel 79 Hayes 80 Sioux 81 Rock 82 Keya Paha 83 Garfield 84 Wheeler 85 Banner 86 Blaine 87 Logan 88 Loup 89 Thomas 90 McPherson 91 Arthur 92 Grant 93 Hooker

** Limited to embryos/genetic products of approved farm products listed above.