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UCC 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 />Panowicz I Michael I A. <br />10. MISCELLANEOUS: <br />2004053/4 <br />' THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />insert only one name (11a or 11b) - do not abbreviate or combine names <br />I la. UnUANILii I IUN J NAMC <br />OR <br />11b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME <br />11c. MAILING ADDRESS CITY STATE IPOSTALCODE <br />11d. TAX ID #: SSN OR EIN A 119. TYPE OF ORGANIZATION 11f. JURISDICTION OF ORGANIZATION 11g. ORGANIZATIONAL ID A', if any <br />ORGANIZATION <br />DEBTOR <br />12. ❑ ADDITIONAL SECURED PARTY'S or ❑ ASSIGNOR S /P'S NAME - insert only one name (12a or 12b) <br />12a. ORGANIZATION'S NAME <br />OR <br />12b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME <br />12c, MAILING ADDRESS CITY STATE POSTAL CODE <br />SUFFIX <br />COUNT <br />IV <br />COUNTRY <br />13. This FINANCING STATEMENT covers ❑ timber to be cut or ❑ as- extracted 16. Additional collateral description: <br />collateral, or is filed as a ❑ fixture filing. <br />14. Description of real estate: <br />SW114W112SE114 31.12.10 <br />15. Name and address of a RECORD OWNER of above - described real estate <br />(if Debtor does not have a record interest): <br />Michael A. Panowicz and Patricia M. Panowicz <br />10288 W White Cloud Road <br />Cairo, NE 68824 <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 ❑ 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) Bankers Systems, Inc., St. Cloud, MN Form UCC- lADD -LAZ 5/30/2001 <br />