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OR 11a. ORGANIZATION'S NAME 11b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 11 c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY 11d. SEE INSTRUO1ION5 ADD'L INFO RE j 11 e. TYPE OF ORGANIZATION ORGANIZATION ll t JURISDICTION OF ORGANIZATION 11g. ORGANIZATIONAL ID 5, if any I NONE DEBTOR I 12. OR J ADDITIONAL SECURED PARTY'S g iJ ASSIGNOR S/P'S NAME • insert only =name (12a or 12b) 12a. ORGANIZATIONS NAME 1 2b. INDMDUALS LAST NAME FIRST NAME SADDLE NAME SUFFIX 12c. MAILING ADDRESS cry STATE POSTAL CODE COUNTRY 13. This FINANCING STATEMENT covers , timber to be cut or .. as- collateral, or is filed as a 3 fixture filing, 14. Description of real estate:. NE 1/4 SEC. 33 T - 12N R - 11 W, HALL COUNTY, NE 15. Name and address of a RECORD OWNER of above- described real Of Debtor does not have a record interest): MICHAEL A. & PATRICIA M. extracted estate 16, Additional cola al description: PANOWICZ 17. Check only if applicable and check only one box. Debtor is a ❑ Trust or n Trustee acting with respect to property held in trust or n Decedents Estate 8. Check only if applicable and check say one box I Debtor's a TRANSMITTING UTILITY I Filed in connection with a Manufactured -Horne Transaction — effective 30 years • Filed in connection with a Public - Finance Transaction — effective 30 years NAME OF FIRST DEBTOR Oa or 1b) ON RELATED FINANCING STATEMENT 9a' ORGANIZATION'S NAME 9b. INDIVIDUAL'S LAST NAME PANOWICZ MISCELLANEOUS: FIRST NAME MICHAEL MIDDLE NAME,SUFFIX UCC FINANCING STATEMENT ADDENDUM FOLLOW INSTRUCTIONS Sfront and back) CAREFULLY 9. OR 10. 11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAAIE - insert only ppe name (11a or 11b) - do not abbreviate or combine names FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (FORM UCCIAd) (REV. 05122/02) 201302952 THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY