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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 O <br />OR <br />9b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME,SUFFIX <br />WORDELL CYNTHIA C <br />10. MISCELLANEOUS <br />12. " ADDITIONAL SECURED PARTY'S or " ASSIGNOR S /P's NAME - insert only one name (12a or 1 <br />12a. ORGANIZATION'S NAME <br />OR <br />i <br />13. This FINANCING STATEMENT covers 1-1 timber to be cut or ❑ as- extracted <br />collateral or is filed as a Fx] fixture filing. <br />14. Description of real estate: <br />Description: W 1/2 SEC 1. TWP 9N, RG 12W OF HALL <br />CO NEBRASKA; E 1/2 SEC 1 ,TWP 9N, RG 12W OF HALL <br />CO 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 />CYNTHIA WORDELL & J KIPP CHARLTON <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. 05/22/02 Prepared by 91209 -90 Services. Inc., P.O. Box 2907 <br />( ) ( ) Glendale, CA 91209 -9071 Tel (800) 331 -3282 <br />Z <br />6290215 -41 -1 <br />- - <br />514060 IFARMCRD <br />200406330 <br />267 <br />File With: Hall, NE <br />= <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 <br />G <br />11a. ORGANIZATION'S NAME <br />OR <br />11 b. INDIVIDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />11 c. MAILING ADDRESS <br />CITY <br />STATE <br />I POSTAL CODE <br />COUNTRY <br />I td. SEE INSTRUCTION <br />DD'L INFO RE <br />11e. TYPE OF ORGANIZATION <br />11f. JURISDICTION OF ORGANIZATION <br />11g. ORGANIZATIONAL ID #, if any <br />RGANIZATION <br />EBTOR <br />NONE <br />12. " ADDITIONAL SECURED PARTY'S or " ASSIGNOR S /P's NAME - insert only one name (12a or 1 <br />12a. ORGANIZATION'S NAME <br />OR <br />i <br />13. This FINANCING STATEMENT covers 1-1 timber to be cut or ❑ as- extracted <br />collateral or is filed as a Fx] fixture filing. <br />14. Description of real estate: <br />Description: W 1/2 SEC 1. TWP 9N, RG 12W OF HALL <br />CO NEBRASKA; E 1/2 SEC 1 ,TWP 9N, RG 12W OF HALL <br />CO 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 />CYNTHIA WORDELL & J KIPP CHARLTON <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. 05/22/02 Prepared by 91209 -90 Services. Inc., P.O. Box 2907 <br />( ) ( ) Glendale, CA 91209 -9071 Tel (800) 331 -3282 <br />Z <br />