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FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS (front and back) CAREFULLY <br />C <br />9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT 200405058 <br />9a. ORGANIZATION'S NAME <br />OR <br />9b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME,SUFFIX <br />JANTZI �, , �,.yvv' RODNEY D <br />10. MISCELLANEOUS <br />t 47598 -40 -1 <br />514060 IFARMCRD <br />K: . <br />0 <br />267 <br />File with: Hall, NE <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only one name (11a or 11 b) - do not abbreviate or combine names 'Sf3 <br />11 a. ORGANIZATION'S NAME <br />OR <br />11 b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX <br />11 c. MAILING ADDRESS CITY STATE I POSTAL CODE COUNTRY <br />11d. TAX ID#: SSN OR EIN DD'L INFO RE 11e. TYPE OF ORGANIZATION 11f. JURISDICTION OF ORGANIZATION 11 g. ORGANIZATIONAL ID #, if any <br />RGANIZATION <br />EBTOR I 1 11 NONE <br />12. ❑ ADDITIONAL SECURED PARTY'S or ❑ ASSIGNOR S /P's NAME - insert only one name (12a or 12b) <br />FILING OFFICE COPY - NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 07/29/98) <br />Prepared by UCGDirect Services, Inc., P.O. Box 29071 <br />Glendale, CA 91209 -9071 Tel (800) 331 -3282 <br />v <br />12a. ORGANIZATION'S NAME <br />DR <br />12b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />i <br />12c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <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 Fx] fixture filing. <br />14. Description of real estate: <br />Description: SW 1/4 SEC 16 TWP 11N RG 12W OF HALL <br />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 />FERN L JANTZI W /CONTRACT TO BUY FOR RODNEY & <br />17. Check only if applicable and check only one box. <br />JENNIFER JANTZI <br />Debtor is a ❑Trust or ❑ Trustee acting with respect to property held in trust or Decedent's Estate <br />18. Check only if applicable and check only one box. <br />❑ Debtor is 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. 07/29/98) <br />Prepared by UCGDirect Services, Inc., P.O. Box 29071 <br />Glendale, CA 91209 -9071 Tel (800) 331 -3282 <br />v <br />