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UCC FINANCING STATEMENTADDENDUM <br />FOLLOW INSTRUCTIONS (front and back) CAREFULLY <br />9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FlNANCING STATEMENT <br />9a. ORGANIZATION'S NAME <br />BOSSELMAN PUMP & PANTRY, INC. <br />OR <br />9b. INDIVIDUAL'S LAST NAME FIRST NAME MI <br />70. MISCELLANEOUS: <br />FIRST NAME <br />CITY <br />� THE ABOVE SPACE IS FOR FlLING OFFICE USE ONLY <br />11. ADDITIONAL DEBTOR EXACT FULL LEGAL NAME - insert only ona name (11a or 11 b) - do rrot abbrevfate w combine names <br />11a. ORGANIZATION'S NAME <br />OR ��b. INDIVIDUAL'S LAST NAME FIRST NAME <br />11c. MAILINGADDRESS CITY <br />11d. SEE INSTRUCTIONS ADD'L INFO RE '11e. TYPE OF ORGANIZATION 11f. JURISDICTION OF ORGANIZATION <br />ORGANIZATION <br />DEBTOR <br />12. ADDITIONAL SECURED PAR1Y'S or ASSIGNOR S/P'S �ME -insertonlyonenarr�(12aor12b) <br />OR �Zb. INDIVIDUAL'S LAST NAME <br />12c. MAIUNG ADDRESS <br />13. This FINANCING STATEMENT c:overs u timbar to ba cut or U asextracted <br />collaterel, or is filed as a��re filing. <br />14. Descrfption of real estate: <br />LOTS ONE (1), TV110 (2�, THREE (31, FOUR (4), FIVE (5) <br />AND SIX (6�, IN BLOCK FIVE (5), IN THE ORIGINAL TOWN <br />OF CAIRO, HALL COUNTY, NEBRASKA AND <br />— LOT TWO (2i, JOHNSON SUBDIVISION, AN ADDITION TO <br />THE VILLAGE OF DONIPHAN, HALL COUNTY, NEBRASKA. <br />15. Name and address of a RECORD OWNER of above-described real astate ('rf <br />Debtor does not have a record interest): <br />BOSSELMAN PUMP & PANTRY, INC. <br />3123 W. STOLLEY PARK ROAD, SUITE A <br />GRAND ISLAND, NE 68801 <br />CODE <br />#, N any <br />Additlonalcollateraldescription: <br />�01207930 <br />COUNTRY <br />17. Check onl ff applicable and check onl one box. <br />Debtor is a� Trust or � Trustee ading with r�pect to property hetd in Vust or n DecedenYs EsMate <br />18. Chack o� H applicable and check onl one box. <br />Debtor is a TRANSMITTING UTILITY <br />Filed in connection with a Manutactured-Home Transaction <br />Filed in connec[ion with a Public-Fnance Transaction <br />Harland Flnancial Solutfons <br />FlLING OFFlCE COPY — UCC FlNANCING STATEMENT ADQENDUM (FORM UCC1A� (REV. 05/21/09) 400 S.W. 6th Avenue, Portland, Oregon 97204 <br />