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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 <br />9a. ORGANIZATION'S NAME <br />OR <br />9b. INDIVIDUAL'S LAST NAME FIRST NAME MIC <br />HARTMAN THOMAS L <br />10. MISCELLANEOUS: <br />200304056 <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only ong name (11a or 11b) - do not abbreviate or combine names <br />FILING OFFICE COPY— NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 07/29/98) <br />NATUCCI - 5/4/01 C T System Online <br />IIII <br />0 <br />i <br />11 a. ORGANIZATION'S NAME <br />OR <br />11 b. INDIVIDUAL'S LAST NAME <br />FIRST NAME MIDDLE NAME <br />SUFFIX <br />11c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />11d. TAX ID #: SSN OR EIN <br />ADD'L INFO RE 11e. 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 Q ASSIGNORS /P'S <br />NAME -insert only gn& name (12aor12b) <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 />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 ® fixture filing. <br />14. Description of real estate: <br />NW 1/4 SEC. 10, TWP. 10, RG. I 1 <br />HALL CO., NE <br />15. Name and address of a RECORD OWNER of above- described real estate <br />(if Debtor does not have a record interest): <br />RICHARD L. HARTMAN <br />17. Check mPly if applicable and check gnly one box. <br />Debtor is a p Trust or Trustee acting with respect to property held in trust or <br />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 />NATUCCI - 5/4/01 C T System Online <br />IIII <br />0 <br />i <br />0 <br />i <br />