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f• <br />FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS (front and back) CAREFULLY <br />9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT <br />9a. ORGANIZATION'S NAME <br />OR <br />9b. INDIVIDUAL'S LAST NAME <br />BROCKH <br />FIRST NAME <br />TERRY <br />MIDDLE NAME,SUFFIX <br />4S <br />20040-5125 <br />10. MISCELLANEOUS <br />86249397 -40 -1 <br />614060 IFARMCRD <br />i 4 <br />1 <br />267 <br />�SU <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 (1 la or 11 b) - do not abbreviate or combine names <br />11 a. ORGANIZATION'S NAME <br />OR <br />11b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />11 c. MAILING ADDRESS <br />CITY <br />t <br />STATE <br />I POSTAL CODE <br />COUNTRY <br />_ 11 d. TAX ID#: SSN OR EIN <br />DDT INFO RE <br />11e. TYPE OF ORGANIZATION <br />111. JURISDICTION OF ORGANIZATION <br />11 g. ORGANIZATIONAL ID #, if any <br />RGANIZATION <br />❑ <br />EBTOR <br />NONE <br />12. <br />❑ ADDITIONAL SECURED PARTY'S or ❑ ASSIGNOR S /P's NAME - insert only one name (12a or 12b) <br />L2a. ORGANIZATION'S NAME <br />OR <br />. -._.. ,. ..... _.,... CI AIAKI MIr1rN F NAMF RIIFFIX <br />13. This FINANCING STATEMENT covers ❑ timber to be cut or I LI I as- extracted <br />collateral or is filed as a � fixture filing. <br />14. Description of real estate: <br />Description: SW 1/4 & S 1/2 NW 1/4 SEC 19 TWP 11N <br />RG 12W OF 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 />STEVEN T & TERRENCE C BROCKHAUS <br />16. Additional collateral description: <br />17. Check only if applicable and check only one box. <br />Debtor is a ❑Trust or []Trustee acting with respect to property held in trust or 11 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 Prepared by 9120 -90 Services, Inc.. P.O. Box 29071 <br />( ) ( ) Glendale, CA 91209 -9071 Tel (800) 331 -3282 <br />v <br />