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UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS <br />9. N <br />AME OF FIRST DEBTOR: Same as line la or lb on Financing Statement if line lb was left blank <br />because Individual Debtor name did not fit, check here ❑ <br />OR <br />9a. ORGANIZATION'S NAME <br />9b. INDIVIDUAL'S SURNAME <br />JENSEN <br />FIRST PERSONAL NAME <br />PATTI <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />2022O008q <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />10. DEBTOR'S NAME: Provide (10a or 10b) only me 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 />Ida. ORGANIZATION'S NAME <br />10b. INDIVIDUAL'S SURNAME <br />12. ADDITIONAL SPACE FOR ITEM 4 (Collateral): <br />411 NORTH SHADY BEND ROAD <br />GRAND ISLAND, NE 68801 <br />THIS FILING IS MADE FOR NOTICE PURPOSES ONLY. THE DEBTOR HAS NO OWNERSHIP RIGHTS IN THE <br />COLLATERAL. THE DEBTOR IS LEASING THE 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 />pcovers timber to be cut ❑ covers as -extracted collateral is filed as a fixture filing <br />15. Name and address of a RECORD OWNER of real estate described in item 16 <br />P (TTIoJENSEN e a record interest): <br />4111NORTH SHADY BEND ROAD <br />GRAND ISLAND, NE 68801 <br />16. Description of real estate: <br />ALL THAT LOT, PIECE OR PARCEL OF LAND, SITUATE IN THE <br />CITY OF GRAND ISLAND, COUNTY OF HALL, STATE OF <br />NEBRASKA, BEING KNOWN AND DESIGNATED AS LOT 1, <br />FAIRACRES DAIRY EIGHTH SUBDIVISION. <br />PARCEL #: 400146010 <br />17. MISCELLANEOUS: <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (Form UCC1Ad) (Rev. 04/20/11) <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 />ADDITIONAL SECURED PARTY'S NAME <br />1 <br />• <br />ASSIGNOR SECURED PARTY'S NAME: <br />Provide only Qpg 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 />411 NORTH SHADY BEND ROAD <br />GRAND ISLAND, NE 68801 <br />THIS FILING IS MADE FOR NOTICE PURPOSES ONLY. THE DEBTOR HAS NO OWNERSHIP RIGHTS IN THE <br />COLLATERAL. THE DEBTOR IS LEASING THE 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 />pcovers timber to be cut ❑ covers as -extracted collateral is filed as a fixture filing <br />15. Name and address of a RECORD OWNER of real estate described in item 16 <br />P (TTIoJENSEN e a record interest): <br />4111NORTH SHADY BEND ROAD <br />GRAND ISLAND, NE 68801 <br />16. Description of real estate: <br />ALL THAT LOT, PIECE OR PARCEL OF LAND, SITUATE IN THE <br />CITY OF GRAND ISLAND, COUNTY OF HALL, STATE OF <br />NEBRASKA, BEING KNOWN AND DESIGNATED AS LOT 1, <br />FAIRACRES DAIRY EIGHTH SUBDIVISION. <br />PARCEL #: 400146010 <br />17. MISCELLANEOUS: <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (Form UCC1Ad) (Rev. 04/20/11) <br />