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OK <br />1 1 b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />11c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />11d. <br />SEE INSTRUCTIONS <br />ADD'L INFO RE 11le. TYPE OF ORGANIZATION <br />ORGANIZATION <br />DEBTOR ( <br />11f. JURISDICTION OF ORGANIZATION <br />11g. ORGANIZATIONAL ID #, if any <br />[1 NONE <br />12 . - 1 <br />OR <br />ADDITIONAL SECURED PARTY'S nr n ASSIGNOR SIPS NAME - insert only gII3 name (12a or 12b) <br />12a. ORGANIZATIONS NAME <br />12b. INDIVIDUALS LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />12c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />13. This FINANCING STATEMENT covers. timber to be cut or . as- extracted <br />collateral, or is filed as a , fixture filing. <br />14. Description of real estate: <br />SEE ATTACHED LEGAL DESCRIPTION <br />15. Name and address of a RECORD OWNER of above-described real estate <br />(if Debtor does not have a record interest): <br />RANDALL HARTMANN <br />509 VINE STREET <br />GRAND ISLAND, NE 68801 <br />16. Additional collateral description: <br />17. Check gply if applicable and check gt1LY one box. <br />Debtor is a n Trust orn Trustee acting with respect to property held in trust or 11 Decedent's Estate <br />18. Check gOly if applicable and check play one box. <br />Debtor is a TRANSMITTING UTILITY <br />Filed in connection with a Manufactured -Home Transaction <br />Filed in connection with a Public-Finance Transaction <br />UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS (front and back) CAREFULLY <br />9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT <br />OR <br />10. <br />11. ADDITIONAL DEBTORS EXACT FULL LEGAL NAME - insert only one name (11a or 11 b) - do not abbreviate or combine names <br />11a. ORGANIZATION'S NAME <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 05/21/09) <br />2 01300843 <br />9a. ORGANIZATIONS NAME <br />9b. INDIVIDUALS LAST NAME <br />HARTMANN <br />MISCELLANEOUS: <br />FIRST NAME <br />JUSTIN <br />MIDDLE NAME,SUFFIX <br />RILEY <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />International Association of Commercial Administrators (IA <br />