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OR 21b, INDIVIDUALS SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S) /INITIAL(S) SUFFIX 21c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY OR 22a. ORGANIZATION'S NAME 22b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S) / INITIAL(S) SUFFIX 22c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY UCC FINANCING STATEMENT ADDITIONAL PARTY FOLLOW INSTRUCTIONS NAME OF FIRST DEBTOR: Same as line la or 1b on Financing Statement; if line lb was left blank because Individual Debtor name did not fit, check here ❑ 18a. ORGANIZATION'S NAME 18b. INDIVIDUAL'S SURNAME PANOWICZ - FIRST PERSONAL NAME JOHN A ADDITIONAL NAME(S) /INITIAL(S) SUFFIX 18. OR THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 19. ADDITIONAL DEBTORS NAME: Provide only Qne Debtor name (19a or 19b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name) 19a. ORGANIZATION'S NAME 19b. INDIVIDUAL'S SURNAME PANOWICZ MAILING ADDRESS 01 N CAMERON RD FIRST PERSONAL NAME JOHN CITY CAIRO ADDITIONAL NAME(S) /INITIAL(S) ALLAN STATE NE POSTAL CODE 68824 OR 19c. 78 20. ADDITIONAL DEBTOR'S NAME: Provide only one Debtor name (20a or 20b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name) 20a. ORGANIZATION'S NAME 20b. INDIVIDUAL'S SURNAME PANOWICZ MAILING ADDRESS 01 N CAMERON RD FIRST PERSONAL NAME SARITA CITY CAIRO ADDITIONAL NAME(S) /INITIAL(S) ANN STATE NE POSTAL CODE 68824 OR 20c. 78 21. ADDITIONAL DEBTOR'S NAME: Provide only one Debtor name (21a or 2 b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name) 22. I ADDITIONAL SECURED PARTY'S NAME 4[ n ASSIGNOR SECURED PARTY'S NAME: Provide only me name (22a or 22b) 23a. ORGANIZATION'S NAME 23b. INDIVIDUAL'S SURNAME MAILING ADDRESS FIRST PERSONAL NAME CITY ADDITIONAL NAME(S) /INITIAL(S) STATE POSTAL CODE 23. OR 23c 21a, ORGANIZATION'S NAME ADDITIONAL SECURED PARTY'S NAME 4r 24. MISCELLANEOUS: 201305958 ASSIGNOR SECURED PARTY'S NAME: Provide only o, ng name (23a or 23b) SUFFIX COUNTRY SUFFIX COUNTRY SUFFIX COUNTRY International Association of Commercial Administrators (IACA) FILING OFFICE COPY — UCC FINANCING STATEMENT ADDITIONAL PARTY (Form UCC1AP) (Rev. 08/22/11)