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J °•••••• ANCING STATEMENT AMENDMENT ,TRUCTIONS N - HONE OF CONTACT AT FILER (optional) CS1 (800) 331 - 3282 Fax: (818) 662 - 4141 )NTACT AT FILER (optional) - LS_Glendale_Custorner_Service@wolterskfuwer.com <NOWLEDGMENT TO: (Name and Address) 201207991 9/25/2012 CC NE Hall 5. ❑ PARTY INFORMATION CHANGE: Check one of these two boxes: This Change affects ❑ Debtor or ❑ Secured Party of record 6. CURRENT RECORD INFORMATION: Complete for Party Information Change - provide only one name (6a or 6b) OR OR OR 7a. ORGANIZATION'S NAME 7b. INDIVIDUAL'S SURNAME INDIVIDUAL'S FIRST PERSONAL NAME INDIVIDUAL'S ADDITIONAL NAME(SWINITIAL(S) 7c. MAILING ADDRESS Pin #: 400417804 See Exhibit "A" attached hereto and made a part hereof. CITY If this is an Amendment authorized by a DEBTOR, check here n and provide name of authorizing Debtor 10. OPTIONAL FILER REFERENCE DATA: Debtor Name: CHT GRAND ISLAND NE SENIOR LIVING, LLC 58504274 FN - 605 R FILING OFFICE COPY — UCC FINANCING STATEMENT AMENDMENT (Form UCC3) (Rev. 04/20/11) STATE N CD Z I- VI PO co C 25758 - KEY BANK REAL ! ` r> N.) Sox 29071nS V4 58504274 o Y Glendale, CA 91209 -9071 N E N E ; cn FIXTURE ° File with: Hall, NE THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY I.— it CO la. INITIAL FINANCING STATEMENT FILE NUMBER 1b. El This FINANCING STATEMENT AMENDMENT is to be filed [for record] (or recorded) in the REAL ESTATE RECORDS Filer: attach Amendment Addendum (Form UCC3Ad) and provide Debtors name in item 13 2. El TERMINATION: Effectiveness of the Financing Statement identified above is terminated with respect to the security interest(s) of Secured Party authorizing this Termination Statement 3. ❑ ASSIGNMENT (full or partial): Provide name of Assignee in item 7a or 7b, and address of Assignee in item 7c and name of Assignor in item 9 For partial assignment, complete items 7 and 9 and also indicate affected collateral in item 8 4. ® CONTINUATION: Effectiveness of the Financing Statement identified above with respect to the security interest(s) of Secured Party authorizing this Continuation Statement is continued for the additional period provided by applicable law AND Check one of these three boxes to: CHANGE name and /or address: Complete ADD name: Complete item ❑ item 6a or 6b; and item 7a or 7b and item 7c ❑ 7a or 7b, and item 7c 6a. ORGANIZATION'S NAME CHT GRAND ISLAND NE SENIOR LIVING, LLC 6b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S)/INITIAL(S) 7. CHANGED OR ADDED INFORMATION: Complete for Assignment or Party Information Change - provide only one name (7a or 7b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name) POSTAL CODE 8. ❑ COLLATERAL CHANGE: Also check one of these four boxes: ❑ ADD collateral ❑ DELETE collateral ❑ RESTATE covered collateral ❑ ASSIGN collateral Indicate collateral: Property Address: 3990 W. Capital Ave, Grand Island, NE 68803 9. NAME OF SECURED PARTY OF RECORD AUTHORIZING THIS AMENDMENT: Provide only one name (9a or 9b) (name of Assignor, if this is an Assignment) 9a. ORGANIZATION'S NAME FANNIE MAE 9b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S)/INITIAL(S) 10061244 --1 DELETE name. Give record name to be deleted in item 6a or 6b SUFFIX SUFFIX COUNTRY SUFFIX Prepared by CT Lien Solutions, P.O. Box 29071, Glendale, CA 91209 -9071 Tel (800) 331 -3282