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OR <br />20a. ORGANIZATION'S NAME <br />20b. INDIVIDUAL'S SURNAME <br />THESENVITZ <br />FIRST PERSONAL NAME <br />LORI <br />ADDITIONAL NAME(S) / INITIAL(S) <br />ANN <br />SUFFIX <br />20c. MAILING ADDRESS <br />11563 SOUTH SHOEMAKER ISLAND RD <br />CITY <br />WOOD RIVER <br />STATE <br />NE <br />POSTAL CODE <br />68883 <br />COUNTRY <br />OR <br />21a. ORGANIZATION'S NAME <br />21b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S) /INITIAL(S) <br />SUFFIX <br />21c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />22. <br />OR <br />ADDITIONAL SECURED PARTY'S NAME <br />g,( <br />IN <br />ASSIGNOR SECURED PARTY'S NAME: Provide only gm name (22a or 22b) <br />22a. ORGANIZATION'S NAME <br />22b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S) /INITIAL(S) <br />SUFFIX <br />22c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />23. <br />OR <br />Q ADDITIONAL SECURED PARTY'S NAME <br />st <br />• <br />ASSIGNOR SECURED PARTY'S NAME: Provide only gag name (230 or 23b) <br />23a. ORGANIZATION'S NAME <br />23b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />23c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />UCC FINANCING STATEMENT ADDITIONAL PARTY <br />FOLLOW INSTRUCTIONS <br />NAME OF FIRST DEBTOR: Same as line 1a or 1b on Financing Statement; if line 1b was left blank <br />because Individual Debtor name did not fit, check here 0 <br />18a. ORGANIZATION'S NAME <br />18b. INDIVIDUAL'S SURNAME <br />THESENVITZ <br />FIRST PERSONAL NAME <br />SCOTT <br />ADDITIONAL NAME(S) /INITIAL(S) <br />W <br />SUFFIX <br />18. <br />OR <br />19. ADDITIONAL DEBTOR'S NAME: Provide only gag Debtor name (19a or 19b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name) <br />19a. ORGANIZATION'S NAME <br />19b. INDIVIDUAL'S SURNAME <br />THESENVITZ <br />MAILING ADDRESS <br />563 SOUTH SHOEMAKER ISLAND RD <br />FIRST PERSONAL NAME <br />SCOTT <br />CITY <br />WOOD RIVER <br />ADDITIONAL NAME(S) /INITIAL(S) <br />WAYNE <br />STATE <br />NE <br />POSTAL CODE <br />68883 <br />OR <br />19c. <br />11 <br />2014051M <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />20. ADDITIONAL DEBTOR'S NAME: Provide only gag Debtor name (20a or 20b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name <br />1. ADDITIONAL DEBTOR'S NAME: Provide only gag Debtor name (21a or 21b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name) <br />SUFFIX <br />COUNTRY <br />MISCELLANEOUS: <br />International Association of Commercial Administrators (IACA) <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDITIONAL PARTY (Form UCC1AP) (Rev. 08/22/11) <br />