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COLORADO UCC -3 STATEMENT OF CHANGE FULED Copy <br />Approved by Central Indexing System Board <br />Total Fee = $15 per box + $1 Surcharge <br />1ST DEBTOR (Put additional debtors on attachment) <br />SSN /FED Tax ID . 84- 0521460 <br />Name (last, tst) MUTUAL MESA LATERAL ENTERPRISE I For Filing Officer Use Only <br />Street .688 38 ROAD, P.O. BOX 356 <br />City, State, Zip . PALISADE, CO 81526 -0356 <br />ORIGINAL UCC FILING NUMBER <br />#C- 153723 Original Filing Number 972002842 C <br />1ST SECURED PARTY Date & Time of Filing 01 -14 -97 09:57 <br />(Put additional secured parties on attachment) Filing Officer of Orig. Doc. : <br />Name (last,,st) <br />Street <br />City, State, Zip <br />STATE OF COLORADO FOR THE USE AND BENEFICounty Book Number <br />bounty Page Number <br />OF THE DEPARTMENT OF NATURAL RESOURCES, Real Estate Filing Number <br />COLORADO WATER CONSERVTION BOARD <br />1313 SHERMAN STREET, ROOM 721 COUNTY WHERE 1ST DEBTOR RESIDES <br />DENVER, CO 80203 <br />(Use 2 Digit Code From Instruction Page) Og <br />ASSIGNED PARTY <br />(Put additional assigned parties on attachment) <br />Name (Last, ist) <br />Street <br />City, State, Zip <br />RETURN COPY TO <br />Name <br />Street <br />City, State, Zip <br />AMENDMENTS /ASSIGNMENTS ..........................Fold Here <br />MUTUAL MESA LATERAL ENTERPRISE <br />Debtor Signature(s) (Optional) <br />Printed <br />Title <br />CHECK IF APPLICABLE <br />• This statement is to be recorded in the <br />county real estate records ONLY <br />• This statement is to be recorded in real <br />estate AND UCC records. <br />EFS FILING? ❑ Yes ❑ No <br />(If non EFS filing, fill in collateral codes only) <br />(If EFS filing, enter County Code and effective dates) <br />(If EFS filing, and all years covered, leave dates blank) <br />Collateral County From To <br />Code Code Date Date <br />X60— — <br />'—T R712ri 6s'.l ^ t <br />-EERL OF ErtiL <br />CHECK THE APPROPRIATE BOX ($15 each) <br />❑ TERMINATION <br />❑ RELEASE OF COLLATERAL <br />[J AMENDMENT <br />❑ TOTAL ASSIGNMENT <br />❑ PARTIAL ASSIGNMENT <br />COLORADO WATER CONSERVATION BOARD <br />303- 866 -3441 Secured Party Signature(s) (Optional) <br />FAX 303 - 866 -4474 <br />Printed Names) <br />No. 604. Rev. 7 -96. STATEMENT OF CHANGE (UCC -3) Bradford Publishing, 1743 Wazee St., Denver, CO 80202 — (303) 292 -2500 — 6-96 <br />Contact Phone & FAX �1 <br />V <br />