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UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS <br />9. <br />OR <br />AME OF FIRST DEBTOR: Same as line la or lb on Financing Statement; if line lb was left blank <br />ecause Individual Debtor name did not fit, check here ❑ <br />9a. ORGANIZATION'S NAME <br />9b. INDIVIDUALS SURNAME <br />RUZICKA <br />FIRST PERSONAL NAME <br />TERESA <br />L <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />202108360 <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 lb 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 />OR <br />10a. ORGANIZATIONS NAME <br />lOb. INDIVIDUAL'S SURNAME <br />INDIVIDUAL'S FIRST PERSONAL NAME <br />INDIVIDUAL'S ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />10c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />11. <br />OR <br />El ADDITIONAL SECURED PARTY'S NAME <br />QC <br />• <br />ASSIGNOR SECURED PARTY'S NAME: Provide only one name (11a or 11b) <br />11a. ORGANIZATION'S 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 />12. 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 />14. This FINANCING STATEMENT: <br />covers timber to be cut ❑ covers as -extracted collateral V] is filed as a fixture filing <br />15. Name and address of a RECORD OWNER of real estate described in item 16 <br />TERESdoes RUZICKrecord interest): <br />BRIAN G RUZICKA <br />816 E SOUTH ST <br />GRAND ISLAND, NE 68801 <br />16. Description of real estate: <br />Legal Description:PLEASANT VIEW TWELFTH SUB LT 9 BLK 1 <br />County:HALL,NE APN:400449919 <br />Census Tract/Block:11.00/2 Alternate <br />APN:3315-00-0-14097-001-0009 Subdivision:PLEASANT VIEW <br />TWELFTH SUB Legal Lot:9 <br />Legal Block:1 <br />Munic/Township:GRAND ISLAND 2 <br />17. MISCELLANEOUS: <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (Form UCC1Ad) (Rev. 04/20/11) <br />