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UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS (front and back) CAREFULLY <br />9. NAME OF FIRST DEBTOR (la or lb) ON RELATED FINANCING STATEMENT <br />9a. ORGANIZATION'S NAME <br />- - - -- -- --------------------- <br />9b. INDIVIDUAL'S LAST NAME <br />HARGENS <br />FIRST NAME <br />RON <br />MIDDLENAME,SUFFIX <br />OR <br />10, MISCELLANEOUS: <br />11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME Insert only oirg name (11aor1lb)- do not abbreviate or combine names <br />11 a. ORGANIZATION'S NAME <br />R <br />11c. MAIIJNG ADDRESS <br />11d. SEE INSTRUCTIONS <br />12. <br />OR <br />11b INDIVIDUAL'S LAST NAME <br />12:a. ORGANIZATION'S NAME <br />2b. INDIVIDUALS LAST NAME <br />12c. MAILING ADDRESS <br />13. This FINANCING STATEMEN covers a timber to be cut or D as- extracted <br />collateral, or is filed as a ID fixture filing. <br />14. (Description of real estate' <br />SW 1/4 SEC. 26 T -12 R -12, HALL COUNTY, NE <br />15. Name and address of a RECORD OWNER of above - described real estaha <br />(if Debtor does not have a record interest): <br />RONALD G HARGENS LIFE <br />ESTATE <br />ADD'L INFO RE 111 e. I ThE OF ORGANIZATION <br />ORGANIZATION <br />DEBTOR <br />FIRST NAME <br />CITY STATE <br />ADDITIONAL SECURED PARTY'S o • ASSIGNOR S/P'S NAME - insert only rine name (12a or 12b) <br />FIRST NAME <br />CITY <br />16. Additional coll ateral description <br />201210'752 <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (FORM UCCIAd) (REV. 05 /22/02) <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />MIDDLE NAME <br />POSTAL CODE <br />11 t JURISIJICTION OP ORGANIZATION 1 lg. ORGANVATIQNAL ID #. if aiW <br />MIDDLE NAME <br />STATE POSTAL CODE <br />SUFFIX <br />COUNTRY <br />SUFFIX <br />COUNTRY <br />17. Check g ly if applicable and check only one box. <br />Debtor is a [Trust or n Trustee acting with respect to pro IV held in trust or n Decedent's Estate <br />18. Check yiy if applicable and check only one box. <br />Debtor is a TRANSMITTING UTILITY <br />Filed In connection with a Manufactured -Horne Transaction — effectbas 30 years <br />Filed in connection with a Public- Finance Transaction effective 30 years <br />NONE <br />