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OR <br />10a. ORGANIZATION'S NAME <br />10b. INDIVIDUALS SURNAME <br />WOITASZEWSKI <br />INDIVIDUAL'S FIRST PERSONAL NAME <br />AMBER <br />INDIVIDUAL'S ADDITIONAL NAMES) / INITIAL(S) <br />M <br />SUFFIX <br />10c. MAILING ADDRESS <br />10919 W CAPITAL AVE. <br />CITY <br />WOOD RIVER <br />STATE <br />NE <br />POSTAL CODE <br />68883 <br />COUNTRY <br />11. <br />OR <br />ADDITIONAL SECURED PARTY'S NAME Q 0 ASSIGNOR SECURED PARTY'S NAME: Provide only one name (1la or 11b) <br />11a. ORGANIZATIONS NAME <br />11b. INDIVIDUALS SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S) /INITIAL(S) <br />SUFFIX <br />11c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS <br />AME OF FIRST DEBTOR: Same as line la or 1b on Financing Statement; if line 1b was left blank <br />ecause Individual Debtor name did not fit, check here <br />9a. ORGANIZATION'S NAME <br />9b. INDIVIDUALS SURNAME <br />WOITASZEWSKI <br />FIRST PERSONAL NAME <br />ADAM <br />L <br />ADDITIONAL NAME(S) / INITIAL(S) <br />SUFFIX <br />9. <br />OR <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />10. DEBTOR'S NAME: Provide (10a or 10b) only one additional Debtor name or Debtor name that did not fit in line 1 b or 2b of the Financing Statement (Form UCC1) (use exact, full name; <br />do not omit, modify, or abbreviate any part of the Debtor's name) and enter the mailing address in line 10c <br />ADDITIONAL SPACE FOR ITEM 4 (Collateral): <br />13. m This FINANCING STATEMENT is to be filed [for record] (or recorded) in the <br />REAL ESTATE RECORDS (if applicable) <br />15. Name and address of a RECORD OWNER of real estate described in item 16 <br />(if Debtor does not have a record interest): <br />17. MISCELLANEOUS: <br />14. This FINANCING STATEMENT: <br />❑ covers timber to be cut ❑ covers as-extracted collateral is filed as a fixture filing <br />16. Description of real estate: <br />201501094 <br />S1 /2NE1 /4 33- 11 -11, HALL COUNTY, NEBRASKA <br />International Association of Commercial Administrators (IACA) <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (Form UCC1Ad) (Rev. 04/20/11) <br />