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y l - - <br />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 />Cobler Jr. <br />10. MISCELLANEOUS: <br />Thomas <br />dM 50,6235 <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />11, ADDITIONAL EXACT FULL LEGAL NAME - insert only one name 111a or 11 b) - do not abbreviate or combine names <br />11 a. ORGANIZATION'S NAME <br />OR 11 b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX <br />11 c. MAILING ADDRESS CITY STATE 1POSTALCODE COUNTRY <br />11 d- TAX ID #: SSN OR EIN ADD'L INFO RE ills. TYPE OF ORGANIZATION 11f. JURISDICTION OF ORGANIZATION 11 g. ORGANIZATIONAL ID #, if any <br />ORGANIZATION <br />DEBTOR I 1 ❑ NONE <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 <br />12c. MAILING ADDRESS <br />13. This FINANCING STATEMENT covers F timber to be cut or ❑ as -e <br />collateral, or is filed as a ® fixture filing. <br />14. Description of real estate, <br />LOT 1, UNIT 115, CONESTOGA MALL <br />SEVENTH SUBDIVISION, GRAND ISLAND, <br />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 />FIRST NAME <br />CITY <br />UNTRY <br />i. Additional collateral description: <br />ad applications for patents, copyrights, trademarks, trade secrets, good <br />rill, trade names, customer lists, permits and franchises, payment <br />itangibles, computer programs and all supporting information provided <br />i connection with a transaction relating to computer programs, and the <br />fight to use Debtor's name. FIXTURES: All goods now or in the future <br />fiixed or attached to real estate. <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 2211 if applicable and check 2=1 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 />SECUREO PARTY COPY -- NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 07/29/98) Hankers Systems, Inc., St. Cloud, MN Form UCC- IAPD -LAZ 5/30/2001 <br />-- -- - - -- .!2__ <br />