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h � t <br />i e <br />UCC FINANCING STATEMENTADDENDUM <br />FOLLOW INSTRUCTIONS (front and back) CAREFULLY <br />9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT <br />9e. ORGANIZATION'S NAME <br />OR <br />gb.INDIVIDUA aiW;F= FIRST NAME MIDDI <br />HARGENS RONALD G. <br />10. MISCELLANEOUS: <br />200315414 <br />( <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY J <br />11. ADDITIONAL DEBTOR EXACT FULL LEGAL NAME - insert only 4Ilfl name (11a or 11b) - do not abbreviate or combine names <br />I;e.11 JAUUIIIUNA L jtL;UKtU ljAKI Y'S <br />12a. ORGANIZATION'S NAME <br />OR 12b. INDIVIDUAL'S LAST NAME <br />12c. MAILING ADDRESS <br />S /P'S NAME -insert only one name <br />13. This FINANCING STATEMENT covers j j timber to be cut or as- extracted <br />collateral, or is filed as a ®fxture filing. <br />14. Description of real estate. <br />SW 1/4 SEC. 26 T-1 2N R-1 2W <br />AND <br />NW-1 /4 SAC:' 12 T#N R -12W HALL` <br />COUNTY, NE <br />r <br />15. Name and address of a RECORD OWNER of above - described real estate <br />(f Debtor does not have a record interest): <br />MARTIN L. HARGENS <br />MONICA R. MADSEN <br />16. Additional collateral description: <br />Debtor is a Trust o rustee acting with respect to property held in trust <br />18. Check only if applicable and check <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- Finanoe Transaction — effective 30 years <br />FILING OFFICE COPY— NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 07129/98) <br />FORM SHOULD BE TYPEWRITTEN OR COMPUTER GENERATED <br />Estate <br />11 e. ORGANIZATION'S NA <br />OR <br />ttb. INDIVIDUAL'S LAST <br />NAME FIRST NAME <br />MIDDLE NAME SUFFIX <br />11c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />lld. TAX ID #: SSN OR EIN <br />ADD'L INFO RE Ile. TYPE OF ORGANIZATION 11f. JURISDICTION OF ORGANIZATION <br />11g. ORGANIZATIONAL ID #, if any <br />ORGANIZATION <br />DEBTOR <br />ONE <br />I;e.11 JAUUIIIUNA L jtL;UKtU ljAKI Y'S <br />12a. ORGANIZATION'S NAME <br />OR 12b. INDIVIDUAL'S LAST NAME <br />12c. MAILING ADDRESS <br />S /P'S NAME -insert only one name <br />13. This FINANCING STATEMENT covers j j timber to be cut or as- extracted <br />collateral, or is filed as a ®fxture filing. <br />14. Description of real estate. <br />SW 1/4 SEC. 26 T-1 2N R-1 2W <br />AND <br />NW-1 /4 SAC:' 12 T#N R -12W HALL` <br />COUNTY, NE <br />r <br />15. Name and address of a RECORD OWNER of above - described real estate <br />(f Debtor does not have a record interest): <br />MARTIN L. HARGENS <br />MONICA R. MADSEN <br />16. Additional collateral description: <br />Debtor is a Trust o rustee acting with respect to property held in trust <br />18. Check only if applicable and check <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- Finanoe Transaction — effective 30 years <br />FILING OFFICE COPY— NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 07129/98) <br />FORM SHOULD BE TYPEWRITTEN OR COMPUTER GENERATED <br />Estate <br />