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UCC FINANCING STATEMENTADDENDUM <br />FOLLOW INSTRUCTIONS front and back CAREFULLY <br />9, NAME OF FIRST DEBTOR (1a yr 1b) ON RELATED FINANCING STATEMENT <br />FN1jAT10N'S NAME <br />OR CI IS:7i._ IDUAL'S LAST NAME FIRST NAME MIDDLE NAME,5UFFIX 200504315 <br />1O.MISCELLANEOUS: <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME- insect only 4Da name (11, or 114), do not abbreviate or combine names <br />I la. ORGANIZATION'S NAME <br />OR <br />i1b.INDIVIOUAL'S LAST NAME <br />FIRST -MF. <br />MIDDLE NAME <br />SUFFIX <br />11C. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL COOS <br />COUNTRY <br />11d. TAX IO N: SSN OR EIN <br />ADUL INI'O RE tie. TYPE OF ORGANIZATION <br />I if.dURISD10TION OF ORGANIZATION fig. ORGANIZATIONAL 10 #, it any <br />ORGANIZATION <br />DEBTOR <br />F11,10NE <br />12. <br />ADDITIONAL SECURED PARTY'S p[ ASSIGNOR SIP'S NAME 124) <br />12a. ORGANIZATION'S NAME <br />OR <br />12b. INDIVIDUAL'S LA5T NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />12c MAILING AODRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />13. This FINANCING STATEMENT covers 0 timber to be Cut or a•extracled <br />16. Additional collateral description: <br />collebrel, or is filed as a91 fixture filing. <br />14. Oeecrlplion of real estate: <br />Lot Fourteen (14), Meadowlark West <br />Fourth Subdivision, in the City of <br />Grand Island, 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 />17. Check g01)f If applicable and check golly one box. <br />Debtor is a n Trust w T—tee acting wllh respect to properly hold In trust or Decedent's Estate <br />18, Check Dolly If applicable and Cheek golly one o0s. <br />Debtor ie a TRANSMITTING UTILITY <br />Filed in connection with a Manufaciurad,K— Transaction -- effective 30 yearn <br />Filed In cn nectlon with a Public-Finence Transaction — effective 30 ears <br />FILING OFFICE COPY— NATIONAL UCC FINANCING STATEMENT ADDENOUM (FORM UCC1Ad) (REV. 07129198) <br />UA.TS4.SZ'Ss! <br />