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arc <br />11b. INDIVIDUALS LAST NAME <br />Suck <br />FIRST NAME <br />Jerron <br />MIDDLE NAME <br />SUFFIX <br />11c. MAILING ADDRESS <br />14570 W Platte River Drive <br />CITY <br />Kenesaw <br />STATE <br />NE <br />POSTAL CODE <br />68956 -9604 <br />COUNTRY <br />USA <br />1Id. SEE INSTRUCTIONS <br />ADD'L INFO RE 111e. TYPE OF ORGANIZATION <br />ORGANIZATION <br />DEBTOR 'Individual <br />11f. JURISDICTION OF ORGANIZATION <br />I <br />11g. ORGANIZATIONAL ID #, if any <br />�(''(( <br />IXINONE <br />12. <br />OR <br />1 ADDITIONAL SECURED PARTY'S or n ASSIGNOR S /P'S NAME - insert only one 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 <br />collateral, or is filed as a fixture filing. <br />14. Description of real estate: <br />The Southeast Quarter (SE114); <br />Seven (7) of County Subdivision <br />(4) and Five (5) and of the South <br />Quarter (S1/2SW1/4) of Section <br />15. Name and address of a RECORD OWNER <br />Debtor does not have a record Interest): <br />, timber to be cut or <br />and Lots Six <br />of Lots Three <br />Half of the Southwest <br />Twenty-five (25), <br />of above - described real <br />. as- extracted <br />(6) and <br />(3), Four <br />estate (If <br />18. Additional collateral description: <br />17. Check off( If applicable and check g 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 or_ik if applicable and check only one box. <br />• Debtor is a TRANSMITTING UTILITY <br />1 Filed in connection with a Manufactured - Home Transaction <br />■ Filed in connection with a Public- Finance Transaction <br />UCC FINANCING STATEMENTADDENDUM <br />FOLLOW INSTRUCTIONS (front and back) CAREFULLY <br />9. <br />OR <br />10. <br />11. ADDITIONAL DEBTORS EXACT FULL LEGAL NAME - Insert only one name (t la or 1I b) • do not abbreviate or combine names <br />1la. ORGANIZATIONS NAME <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 05/21/09) <br />201305064 <br />NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT <br />9a. ORGANIZATION'S NAME <br />9b. INDIVIDUALS LAST NAME <br />Suck <br />MISCELLANEOUS: <br />FIRST NAME <br />Jerron <br />MIDDLE NAME, SUFFIX <br />M <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />Harland Financial Solutions <br />400 S.W. 6th Avenue, Portland, Oregon 97204 <br />