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UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS (front and back) CAREFULLY <br />9. NAME OF FIRST DEBTOR fla or tbl ON RELATED FINANCING STATEMENT <br />OR Chief Industries, Inc. <br />9b. INDIVIDUAL'S LAST NAM <br />10 <br />11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME — insert <br />11a. ORGANIZATION'S NAME <br />200313311 <br />NAME, <br />I THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />name (11 a or 11 b) – do not abbreviate or combine names <br />FILING OFFICE COPY — NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 07/29/98) <br />OPPENHEIMER: 1488553 v01 09/29/2003 <br />"IDUAL'S LAST NAME <br />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />11c. MAILING ADDRESS <br />CITY <br />STATE <br />70DE_ <br />COUNTRY <br />11d. TAX ID# SSNOREIN <br />ADDL INFO RE <br />1'E. TYPEOFCRGANIZATICN <br />11f. JURISDICTION OF ORGANIZATION <br />11g. ORGANIZATIONAL ID #, if any <br />ORGANIZATION <br />DEBTOR <br />1:1 NONE <br />12. <br />F–] 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 />FIRST NAME <br />MIDDLE NAME <br />SUFFIX <br />12c. MAILING ADDRESS <br />CITY <br />STATE. <br />POSTAL CODE <br />COUNTRY <br />13. This FINANCING STATEMENT covers ❑ timber tc -r- ; l or ❑ as-extracted <br />16. Additional calateral desciplim: <br />collateral, or is filed as a 7 fixture filing. <br />14. Description of real estate: <br />A part of Lots 115, 116, 117, 118, 127, and all <br />of Lots 128 thru 138, inclusive, Cottage Grove <br />Addition, and part of vacated Geddes Street <br />adjoining thereon, Hall County, Nebraska <br />15. Name and address of a RECORD OWNER of above- cescnbed real estate <br />(if Debtor does not have a record interest): N/A <br />Robert G. Eihusen <br />17. Check only if applicable and check only one box. <br />306 Gunbarrel Road <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 />Grand Island, Nebraska 68801 <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 />OPPENHEIMER: 1488553 v01 09/29/2003 <br />