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NAmmum FINANCING STATEMENT co co ✓ INSTRUCTIONS 0..1.111111.11 E & PHONE OF CONTACT AT FILER (optional) e11.111.1 C 1-800-858-5294 70 rn z z v rn rr IL CONTACT AT FILER (optional) RFiling@cscglobal.com ACKNOWLEDGMENT �TO: (Name and Address) 0 12515 " CSC rpo (?v,(. 2 4ro9 Springfield, IL 62703-2q0 L Filed In: Nebraska (Hal C. C') CD CI1 C:' f THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 1. DEBTORS NAME: Provide only me Debtor name (la or lb) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name); if any part of the Individual Debtor's name will not fit in line 1b, leave all of item 1 blank, check here and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad) la. ORGANIZATIONS NAME Li II 1b. INDIVIDUAL'S SURNAME RUZICKA FIRST PERSONAL NAME TERESA ADDITIONAL NAME(S)/INITIAL(S) L SUFFIX lc. MAILING ADDRESS 816 E SOUTH ST CITY GRAND ISLAND STATE NE POSTAL CODE 68801 COUNTRY USA 2. DEBTORS NAME: Provide only gng Debtor name (2a or 2b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name); if any part of the Individual Debtors name will not fit in line 2b, leave all of item 2 blank, check here and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad) OR 2a. ORGANIZATION'S NAME 2b. INDIVIDUAL'S SURNAME RUZICKA FIRST PERSONAL NAME BRIAN ADDITIONAL NAME(S)/INITIAL(S) G SUFFIX 2c. MAILING ADDRESS 816 E SOUTH ST CITY GRAND ISLAND STATE NE POSTAL CODE 68801 COUNTRY USA 3. SECURED PARTY'S NAME (or NAME of ASSIGNEE of ASSIGNOR SECURED PARTY): Provide only ons Secured Party name (3a or 3b) OR 3a. ORGANIZATION'S NAME Foundation Finance Company LLC 3b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S)/INITIAL(S) SUFFIX 3c. MAILING ADDRESS 10101 Market Street Suite B100 CITY Rothschild STATE WI POSTAL CODE 54474 COUNTRY USA 4 IIV6EMM5 56dre litZlZgeroiMaIHOME TERESA L RUZICKA h( BRIAN G RUZICKA 816 E SOUTH ST GRAND ISLAND, NE 68801 5. Check oak if applicable and check oily one box: Collateral is held in a Trust (see UCC1Ad, item 17 and Instructions) ❑ being administered by a Decedent's Personal Representative 6a. Check oEb if applicable and check ooI t one box: 6b. Check only if applicable and check only one box: Public -Finance Transaction Manufactured -Home Transaction ❑ A Debtor is a Transmitting Utility ❑ Agricultural Lien ❑ Non -UCC Filing 7. ALTERNATIVE DESIGNATION (if applicable): ❑ Lessee/Lessor ❑ Consignee/Consignor ❑ Seller/Buyer ❑ Bailee/Bailor D Licensee/Licensor 8. OPTIONAL FILER REFERENCE DATA::70079906 /60319580 2190 12515 FILING OFFICE COPY— UCC FINANCING STATEMENT (Form UCC1) (Rev. 04/20/11)