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UCC FINANCING STATEMENT AMENDMENT <br />Filing Fee: $18 <br />Follow Instructions (front and back) Carefully <br />A. NAME & PHONE OF CONTACT (optional) <br />Steve Biondo 303-866-3495 <br />B. SEND ACKNOWLEDGMENT TO: (Name and Address) <br />~ COLORADO WATER CONSERVATION BOARD <br />ATTN: WATER SUPPLY PLANNING & FINANCE <br />1580 LOGAN STREET, SUITE 750 <br />DENVER, COLORADO 80203 <br />i _,s,lj <br />- - i ~-:~Lt 6 i= ~. ~ : ~ 1 e 5r <br />ABOVE SPACE FOR FILING OFFICE USE ONLY <br />1. Initial Financing Statement Information (Required) <br />1a Original Filing Number: 20042113545 1b. Original Filing Date: 10/15/04 1c. If filed prior to January 1, 2000, indicate Original iriling Office: <br />•~ r <br />L~ erminatlOn:Effectiveness of the Finandng Statement identified above is terminated vnlh respect to security interest(s) of the Secured Party authorizing this Termination to men <br />,[t OntlDUatlOn: Effectiveness of the Financing Statement identified above x4M respect to sewnly interest(s) of the Secured Party authorizing this Continuation Statement <br />is continued for the additional period provided by applicable law. <br />. ® SSlgnment: Give name of assgnee in item 7a or 7b and address of assignee in item 7c; also give name of assignor in item 9. <br />men men a n Orma IOn :This Amendment affeds~ebtor or~ecured Party of record. Check onty one of tlrese two boxes. <br />Also check one of the following three boxes and provide appropriate information in items 6 andlor 7. <br />®CHANGE name andlor address: Give current record name in item 6a or 6b; also give ~ DELETE name: Give record name ADD name: Complete item 7a or 7b, and also <br />new name (if name change) in item 7a or 7b and/or new address (if address change) in item 7c. to be deleted in 6a or 6b. item 7c; also complete items 7e~7g (if applicable) <br />6. CURRENT RECORD INFORMATION: <br />6a. ORGANIZATION'S NAME <br />OR LAKE ARROWHEAD WATER ASSOCIATION ~, <br />6b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX <br />7. CHANGED (NEW) OR ADDED INFORMATION: <br />7a. ORGANIZATION'S NAME <br />OR <br />7b. 1NDIV{DUAL'SLASI NAME FIRST NAME MIDDLE NAME SUFFIX <br />7c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY <br />5106 KIOWA DRIVE GREELEY CO 80634 USA <br />7d. TAX ID#: SSN OR EIN ADD'L INFO RE 7e. TYPE OF ORGANIZATION 7f. JURISDICTION OF ORGANIZATION 7g. ORGANIZATION ID#, if any <br />(OPTIONAL: NOT REQUIRED) ORGANIZATION DNC CO 0019901036840 NONE <br />(DEBTOR <br />8. AMENDMENT (COLLATERAL CHANGE): check only one box. <br />Describe collateral !~~deleted or ~ added, or give entire restated collateral description, or describe collateral[~assigned <br />SECURED PARTY'S REVENUES PLEDGED TO REPAY LOAN OF $224,495.70 IN ACCORDANCE WITH LOAN CONTRACT NO. 0150113 AND AS <br />AMENDED, PROMISSORY NOTE DATED DECEMBER 22, 2006. <br />(name of assignor, ii this is an Assignment). It this is an Amendment authorized by a <br />Debtor which adds collateral or adds the authorizing Debtor, or if this is a Termination authorized by a Debtor, check here ~ and enter name of DEBTOR authorizing this Amendment <br />9a. ORGANIZATION'S NAME <br />OR STATE OF COLORADO -COLORADO WATER CONSERVATION BOARD <br />INDIVIDUAL'S LAST NAME <br />10.OPTIONAL FILER REFERENCE DATA <br />LOAN CONTRACT NO. 0150113 <br />FIRST NAME <br />NAME SUFFIX <br />NATIONAL UCC FINANCING STATEMENT AMENDMENT (FORM UCC3) -COLORADO (REV 7/16/2001) <br />