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0 <br />UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS (front and bac CAREFULLY <br />9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT <br />9a. ORGANIZHTION'S NAME <br />oR LUTHERAN HOMES, INC. <br />9b. INDIVIDUALS LAST NAME FIRST NAME MI[ <br />10. MISCELLANEOUS: <br />_ 103-EHO10 <br />201204310 <br />� THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only one name (11a or 11b) - do not abbreviate or combine nam� <br />11a. ORGANIL4TION'S NAME <br />� 11b. INDIVIDUAL'S LAST NAME FlRST NAME MIDDLE NAME SUFF�X <br />11c.MAILINGADDRESS CITY STATE POSTALCODE COUNTRY <br />11d. SEE INSTRUCTIONS ADD'L INFO RE 11e. TYPE OF ORGANI7ATION 11f. JURISDICTION OF ORGANI7I�TION 11g. ORGANIZATIONAL ID #, Hany <br />ORGANVJITION ,—, <br />12. <br />OR <br />ASSIGNOR S/P'S NAME - Insert onlv �na neme (12a or <br />13. This FINANCING STATEMENT mvers� timber to be cut or ❑ as-extracted <br />collaterel, or is flled as a� fixture filing. <br />14. Description of real eatate: <br />See Attached Real Estate Description <br />15. Name and eddress of a RECORD OWNER of above-deacribed real eateta <br />(d Debtor doas not have a record interest): <br />FIRST NAME <br />arr <br />16. Additional cotlateral description: <br />MIDDLE NAME <br />17. Check p� H applicable and check p�y one box. <br />Debtor is a Trust or Truatea ading with respect to pn <br />18. Check ,g�r Jy H applicable and check o� one box. <br />e Debtor ia a TRANSMITTING U77LITY <br />Fled in cainection with a Manufedured-Home Transaction <br />Fled in connadion wlth a PublioFlnance Transactlon <br />IntemaUonal Associati <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 05/21/09) <br />held in trust or � � DecedenYa Eetate <br />