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UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS <br />9. NAME OF FIRST DEBTOR: Same as line la or 1b on Financing Statement; if line 1b was left blank <br />because Individual Debtor name did not fit, check here Ej <br />OR <br />9a. ORGANIZATION'S NAME <br />9b. INDIVIDUAL'S SURNAME <br />MOLINA <br />FIRST PERSONAL NAME <br />ZOILA <br />L. <br />ADDITIONAL NAMES)/INITIAL(S) <br />SUFFIX <br />20220150 <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 hat did not fit in line 1b 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 />R <br />10a. ORGANIZATION'S NAME <br />10b. INDIVIDUAL'S SURNAME <br />INDIVIDUAL'S FIRST PERSONAL NAME <br />INDIVIDUAL'S ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />10b., MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />11. ADDITIONAL SECURED PARTY'S NAME gL ❑ ASSIGNOR SECURED PARTY'S NAME: Provide only one, name (11a or 11b) <br />11 a. ORGANIZATION'S NAME <br />OR <br />11b. INDIVIDUAL'S 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 />1903 W 2ND <br />GRAND ISLAND , NE 68803 <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 />❑ covers timber to be cut ❑ covers as -extracted collateral 121 is filed as a fixture filing <br />15. Name and address of a RECORD OWNER of real estate described in item 16 <br />ZOILA L does riot interest): <br />1903 W 2ND <br />GRAND ISLAND , NE 68803 <br />16. Description of real estate: <br />THE NORTHERLY 90.5 FEET OF LOT 1, IN BLOCK 14, IN <br />BAKER'S ADDITION TO THE CITY OF GRAND ISLAND, HALL <br />COUNTY, NEBRASKA EXPECTING THAT PORTION DEEDED <br />TO THE STATE OF NEBRASKA DEPARTMENT OF ROAD AS <br />DOCUMENT NO. 200604871 <br />Parcel Number: 400013959 <br />17. MISCELLANEOUS: <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (Form UCC1Ad) (Rev. 04/20/11) <br />