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UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS (frond and back) CAREFULLY <br />9. NAME OF FIRST DEBTOR (la Or 11b) ON RELATED FINANCING STATEMENT <br />7. ORGANI2AIION'S NAME <br />OR <br />BABEL I THOMAS <br />200314166 <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />(:AI NAME .,OT fib) do not a bbeons, or <br />Harland Financial Solutions <br />SECURED PARTY COPY — NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 0]12958)400 S.W. fifth Ahenue, Portland, Oregon 1021 <br />11. ORGANIZATION'S NAME <br />GR <br />flb. INDIVIDUAL'S LAST NAME <br />HRSi NAME <br />MIDDLE NAMF <br />SUFFl% <br />11aRA EDADDRESS <br />CITY <br />SIAIt <br />`Q-A- .. E <br />WUMM <br />11d TAX IO B. SSN OR LIIN <br />ADD'LTLARC lle TYPEOFORGANIZATION <br />111. JURISUICIION OFOROANIZATION 11g ORGANIZATIONAL IDp, ll any <br />ORGANIZATION <br />DEBTOR <br />n N.N. <br />12. <br />ADDITIONAL S EC U R E D PARTY'S <br />or ASSIGNORS /P'S NAME- hand only as name IT 2a or 1211 <br />12a. ORGANIZATION'S NAME <br />OR <br />4E. NDIMIOIIALBLASTNAME <br />FIRST NAME <br />MIppLE NAME <br />SUFFIX <br />12, . MAILING AUUREGS <br />CITY <br />STATE <br />POSTAL f.00F <br />COVNTRY <br />13, This FINANCIN09TATEMENT wMem® ll iddi NO or iell—ked <br />16. Addaid— lcollabraldescricen: <br />Ikderxl nr iaelm as a ®bared nlms <br />14. peacnplihh of real wart: <br />LOT FIVE (5), IN RIVERINE SUBDIVISION, <br />AN ADDITION TO THE CITY OF <br />WOOD RIVER, HALL COUNTY, NEBRASKA <br />15. Name and deXrass of a RECORD OWNER Of abnve.deecnbed man ware <br />(b Dered mo no[ Xave a —Y INeni <br />17 _ Lhxk onlyX rpplicableanC Clleckhna bo[ <br />Cehbrlse Trust or T— and, soling wbhmepecl w pmpeM lulam chat or CookanYS <br />C. <br />18. Checker if appl whleand cherk done box <br />C]De bthelz a TRANSMITING UTILITY <br />FIe41 nconreceonwbha Manuh @urer lomernex— Ron— eXiMlNS 30Mars <br />Fneb no with, PUhnn Fire ea T2weilon— etrobefor Gf xns <br />Harland Financial Solutions <br />SECURED PARTY COPY — NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 0]12958)400 S.W. fifth Ahenue, Portland, Oregon 1021 <br />