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UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS (front and back) cCAREFU LY <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />9. NAME OF FIRST DEBTOR (1a or 1b) ON RELA.. <br />D FINANCING STATEMENT <br />OR <br />9a. ORGANIZATIONS NAME <br />9b. INDIVIDUAL'S LAST NAME <br />WIESE <br />FIRST NAME <br />JERRY <br />MIDDLE NAME,SUFFIX <br />10. MSCELLANEOUS: <br />11. <br />ADDITIONAL DEBTOR'S EXACT FULL LEGAL - inert only SUBt name (11a or 11b) - do not abbreviate or combine names <br />OR <br />11a ORGANIZATION'S NAME <br />11b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />11c. MAIUNG ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />11d. SEE INSTRUCTIONS <br />ADD'L INFO RE 111 e. TYP: OF ORGANIZATION <br />ORGANIZATION <br />DEBTOR [ <br />11f. JURISDICTION OF ORGANIZATION <br />11g. ORGANIZATIONAL ID #, if any <br />1 NONE <br />1 2. <br />OR <br />- 1 ADDITIONAL SECURED PARTY'S ox ( ASSIGNOR S/P'S NAME - insert only sulename(12aor12b) <br />12a. ORGANIZATION'S NAME <br />1 21 INDIVIDUAL'S 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 , <br />collateral, or is filed as a 3 fufiue filing. <br />14. Description of real estate: <br />S 1/2 OF SE 1/4 SEC. 15 T -12, R -10, HALL COUNTY, <br />15. Name and address cf a RECORD OWNER of above- described <br />(if Debtor does not have a record interest); <br />JERRY LEE WIESE <br />ut or I <br />real: <br />as- extracted <br />NE <br />estate <br />16. Additional collateral description: <br />17. Check only if applicable and check nIr one box. <br />Debtor isa nTrust or n Trustee acting with respect to property held in trust or n Decedent's. Estate <br />1$. Check only if applicable and check fly one box <br />1 Debtor is a TRANSMITTING UTILITY <br />■ Filed in connection with a Manufactured-Home Transaction- effective 30 years <br />® Filed In connection with a Public -Finance Transaction - effective 30 years <br />FILING OFFICE COPY — UCC FINANCING ST ATEMENT ADDENDUM (FORM UCCIAd) (REV. 05/22/02) <br />201304151 <br />