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UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS (front and back) CAREFULLY <br />9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STA' <br />oR � CHT GRAND ISLAND NE SElvIOR LIVING, LLC <br />� THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only orre name (11a or 11 b) - do rrot abbreviate or combine names <br />OR <br />11g. <br />I�� nav I I I <br />1z• � ADDITIONAL SECURED PARTY'S or � ASSIGNOR S/P'S NAME - insert only one name (12a or 12b) <br />12a. ORGANIU�TION'S NAME <br />oR KEYCORP REAL ESTATE CAPITAL MARI�TS, INC. <br />11501 OUTLOOK STREET, SUITE 300 <br />13. T}tis FlNANCING STA7EMENT cove�s � Umberto be at or ❑� <br />�Ilaterai. or is filed es e ❑ fuduefirug. <br />14. Description of real estate: <br />15. Name end eddress of a RECORD OWNER oF above-de�xibed real estate <br />(H DeMor doea rrot have e record irrterest): <br />OVERLAND PARK <br />18. Addrtior�el oo0ateral desaip6ort <br />20120752� <br />GANVATIONAL ID #, ITeny <br />� NONE <br />NAME SUFFIX <br />KS I 66211 I USA <br />18. Chedc � H appliceble and check ony are box. <br />� Debtor is a TRANSMITTING UTILITY <br />� Filed in connection with e Manufadured-Home Transediort-�AeGive 30 years <br />� Filed in connectlon with a Publio-Finence Trar�saction--eftedive 30 yeara <br />17. Check o�'rf appliceble end chedc oNy mre box <br />Debtor ia a� Trust or � Trustee aetir�g with respect to property held in truat or � D�denYs Estate <br />FILING OFFICE COPY— NATIONAL UCC FINANCING STATEMENTADDENDUM (FORM UCC1Ad) (REV. 07/29/98) 2942554 v.l OS/28/2012 <br />