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rn m � � � rnm � y rn o �� rn � rn �, �o rn � � o o �z � � Z� � y � �� Z �7 CI] c�, z� � � �rn p — w �� p � �Ov � C�1] FfNANC�NC STATEMENT AMENDIIAENT rn� rn � �� m rn � _� ;[] W INSTRIJCTI�NS �� C VIE 8�PH�NE�F C�NTACT AT FfLER(optionaf) �� r� � �nifer 3U$-537-3�$4 �� `J`J z o Q . . CI] � IAiL CaNTACT AT FiLER{optional} � U] � ,�oar��ett a[J71sts#atehank.com � C.SEN❑ACKNQWLEDGMENT T�: {Name and Address} �First State Bank � P�Box 79 Gothenburg,NE 69138 � � THE AB�VE SPACE IS FDR FILING aFFIGE USE�NLY 1a.lNITlAL FfNANCING STATEMENT FILE NlJMBER 1b.❑This FINANCING STATEMENT AMENDMENT is to be filed[fvr record] ZVV'1�i4,�� {or re�orded}in the RERL ESTATE RECQRDS � �iler.�Amsndment Addendum{Fvrm l]CC3Ad]�prvvide Dehta�s name in item 13 2.�TERMINATldN:Effectiveness of the F'ir�ancing 5tatement identified above is termir�ated with respe�t ta the security interest�s}of Secured Party authvrizing this Terminativn 5tatemenf 3.�A551GNMENT{full❑r partial}: Pravide name of Assignee in item 7a ar 7b, r�,address vf Assignee in item 7c�nd name o#Assignor in item 9 For partiaf assignment,compfete items 7 and 9and also indica#e affe�ted colla#erai in item 8 4.�CDNTINIJATIaN: Effectiveness❑f the Financing 5tatement identified abvve with respect t❑fhe security interest�s}of 5ecured Party authoria�g this Continuation 5tatement is cantinusd#ar the additivnai period provided by applicable law 5.�PARTY INFQRMATI�N CHANGE: Check�e af these two baxes: �.��G��ef these three hoxes ta: CHANGE name andlor address: Complete ADCl name: Compiete item �ELETE r�ame: Give record name This Change affects Debtor ar 5ecured Party oi record �item 6a or fib;�,item 7a or 7b an item 7c �7a or 7b,�item 7c �ta be deieted in item Ba or fib 6. CLIRRENT RECOR❑1NF�RMATIDN: Complete for Party infarmation Change-pravide only�ns,name(5a ar fib} fia.�RGANIZATiDN'S NAME Mid-Pla�ns Center for Behavoriat HealthcarQ Ser�ices,In�. �R 6b INDlVIDEJAL'S SURNAME FIRST PERSQNAL NAME ADDITIDNAL NAME(S}IiNITfAL�S} SUF�lX 7. CHANGED QR ADDED INFDRMATI�N: Complete for Assignment ar Party lnformation Change-provide only�ng name�?a or 7b}�use exa�t,fu�l name;do�ot omit,madify,ar abbreviate any part of the nebtQr's name} 7a.QRGAN1ZATiQN'S NAM E �� 7b.IN�IVIDUAL'S SURNAME IN�IVIDUAL'S FIRST PERS�NA�NAME INDIVIDUAL'S A�DITI�NAL.NAME(5}IINITIAL�S} SUF�Ix 7c. MAILING ADdR�55 CITY STATE PDSTAL.CODE C�UNTRY P�Bnx 1753 Grand I�land NE 688UZ USA 8.❑��LLATERAL CHANGE: Also check g�g of these four boxes: ❑ADD col4atera! ❑DE�ETE callateral �✓ RESTATE covered callateral ❑AS51GN cvllateral Indicate�oliateraf; Lncated at 914 Baumann Dr,Grand island,NE 688Q3-A tract of�and compris�ng a part of Lot Z,�olden Age Znd Subdi�isivn,Grand Island,Hall�aunty,Nehraska,more particularly descrihed as fo��ows: Beginning at the N'�V carner of said Lot 2;thence E along the North line of said Lot 2;a distance�f 372.G9 feet;thence deflecting right 135 degrees 37'2Q" and running sauthwester�y,a distanee nf 511.55 feet,tv the West line of said Lat 2;thence northerly along the west line of said Lot Z,a distan�e of 357.8 feet to the place af heginning. 9. NAME QF SECURE❑PARTY�F REC�R❑AUTHQRIZING THIS AMENDMENT: Provide only�e name(9a ar 9�}(name af Assignar,if this is an Assignmen#) If this is an Amendmer�t authorized by a DEBTDR,check here �and pravide r�ame of autharizing Dehtor 9a.QRGANiZATIQN'S NAM� Fi rst State Ba n k ��' 9b.IN�IVIDUAL'S SURNAME FIRST PERS�NAL NAME AODIT�QNAL NAME[5}IiNITIA�{5) SL1�FiX 1�.QPT��NAL FILER REFERENCE DATA: International Associativn vf Cammercial Admin�stratars(�ACA] F!LlNG OFFICE GQPY�--UCC FINANCING STATEMENT AMENDMENT�Form UCC3}[Re�.0412�111}