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UCC FINANCING STATEMENTADDENDUM <br />FOLLOW INSTRUCTIONS (front and back) CAREFULLY <br />9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT 200403260 <br />9a. ORGANIZATION'S NAME <br />OR T & J TIRES AND ASSOCIATES, LLC (DEBTOR) <br />9b. INDIVIDUALS LAST NAME FIRST NAME MIDDLE NAME,SUFFIX <br />10. MISCELLANEOUS: <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME- insert only gM name (11 la or 11b) -do not abbreviate or combine names <br />FILING OFFICE COPY— NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 07/29198) <br />111a. ORGANIZATIONS NAME <br />OR <br />11b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />11c. MAILING ADDRESS <br />CITY <br />STATE <br />TSTALCODE <br />COUNTRY <br />11d. TAX ID #: SSN OR EIN <br />A 1 Ile. TYPE OF ORGANIZATION <br />11f. JURISDICTION OF ORGANIZATION 11g. ORGANIZATIONAL ID #, if any <br />ORGANIZATION <br />DEBTOR <br />NONE <br />12. <br />ADDITIONAL SECURED PARTY'S pr ASSIGNOR SIPS NAME - insert only ging name (12a or 12b) <br />12a. ORGANIZATION'S NAME <br />OR <br />12b. INDIVIDUAL'S LAST NAME <br />FIRST NAME MIDDLE NAME <br />SUFFIX <br />12c. MAILING ADDRESS <br />CITY <br />STATE <br />IPOSTALCODE <br />COUNTRY <br />13. This FINANCING STATEMENT covers timber to be cut or as- extracted <br />16. Additional collateral description: <br />collateral, or is filed as a 11 fixture filing. <br />14. Description of real estate: <br />Legal Description: The Southerly Two Hundred Feet <br />(200') of Lot Thirteen, Menard Second Subdivision, <br />in the City of Grand Island, Hall County, Nebraska. <br />15. Name and address of a RECORD OWNER of above -described real estate <br />(if Debtor does not have a record interest): <br />17. Check Qply if applicable and check Qp(y one box. <br />Debtor is a n Trust or n Trustee acting with respect to property held in trust or Decedent's <br />Estate <br />18. Check gcb if applicable and check gp(y one box. <br />Debtoris a TRANSMITTING UTILITY <br />Filed in connection with a Manufactured -Home Transaction — effective 30 years <br />Filed in connection with a Public- Finance Transaction — effective 30 years <br />FILING OFFICE COPY— NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 07/29198) <br />