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O R <br />11 a. ORGANIZATIONS NAME <br />11b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />11 c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />11d.SEEINSTRUCTIONS <br />ADDL. INFO RE I 11e. TYPE OF ORGANIZATION <br />ORGANIZATION <br />DEBTOR i <br />llf. JURISDICTION OF ORGANIZATION <br />11g. ORGANIZATIONAL ID #, If any <br />L( NONE <br />12.0 ADDITIONAL SECURED PARTY'S et ASSIGNOR S/P'S NAME • insert only one name (12a or 12b) <br />OR <br />12a. ORGANIZATION'S NAME <br />INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />12a. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />13. This FINANCING STATEMENT severs ill timber to be cut or ■ <br />collateral, or is filed as a 3 fixture filing. <br />14. Description of real estate: <br />S 1/2 OF SE 1/4 SEC. 16, T -11 R -11, HALL COUNTY, <br />15. Name and address of a RECORD OWNER of real <br />(0 Debtor does not have a record. interest): <br />MICHAEL J. VOSS <br />as- extracted <br />NE <br />estate <br />16. Additional colateral description: <br />17. Check only if applicable and check only one box. <br />Debtor is a n Trust or n Trustee acting with respect to property held in trust or n Decedent's Estate <br />18. Check only if applicable and check oily one box <br />1 Debtor is a TRANSMITTING UIIUTY <br />Filed in connection with a Manufactured -Home Transaction — effective 30 years <br />® Filed in connection with a Publuc Finance Transaction — effective 30 years <br />UCC FINANCING STATEMENT ADDENDUM <br />AME OF FIRST DEBTOR (1 a or 1 b) ON RELATED FINANCING STATEMENT <br />9a. ORGANIZATIONS NAME <br />FIRST NAME <br />MICHAEL <br />MIDDLE NAME,SUFFIX <br />J <br />FOLLOW INSTRUCTIONS (front and back) CAREFULLY <br />9. <br />OR <br />9b. INDIVIDUAL'S LAST NAME <br />VOSS <br />10. MISCELLANEOUS: <br />11. ADDITIONAL DEBTOR'S EXACT FULL LE <br />AL NAME • insert only one name (11a or 11 • do not abbreviate or combine names <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (FORM UCCIAd) (REV. 05/22/02) <br />20:30419 <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />