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<br />,.. <br /> <br />" <br /> <br />.. <br /> <br />UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS (front and back) CAREFULLY <br /> <br />9, NAME OF FIRST DEBTOR (1a or lb) ON RELATED FINANCING STATEMENT <br />A I A 'SNAME <br /> <br /> <br />FIRST NAME <br /> <br />Cosgriff <br />10, MISCELLANEOUS: <br /> <br />Bernard <br /> <br />200602109 <br /> <br /> <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />I 1. ADDITIONAL D STOR'S EXACT FULL LEGAL NAME - insert only Sll!. name (1 I a or I I b) . do not abbreviate or combine names <br />t la. ORGANIZATION'S NAME <br /> <br />OR <br /> <br />1 tb. INDIVIDUAL'S LAST NAME <br /> <br />1 tc. MAILING ADDRESS CITY <br /> <br />FIRST NAME <br /> <br />MIDDLE NAME <br /> <br />SUFFIX <br /> <br />STATE -rOSTAL CODE <br /> <br /> <br />l1g. ORGANIZATIONAlID #,If any <br /> <br />COUNTRY <br /> <br />lId. TAX ID #: SSN OR EIN I:ADD'LINFO RE 1'1e. TYPE OF ORGANIZATION 111. JURISDICTION OF ORGANIZATION <br />ORGANIZATION I I <br />DEBTOR <br /> <br />I <br /> <br />o NONE <br /> <br />12. 1 ADDITIONAL SECURED PARTY'S or n ASSIGNOR SIP'S NAME - insert only one name (12a or 12b) <br />12a. ORGANIZATION'S NAME <br /> <br />OR <br /> <br />t2b. INDIVIDUAL'S LAST NAME <br /> <br />12c. MAILING ADDRESS <br /> <br />FIRST NAME <br /> <br />MIDDLE NAME <br /> <br />SUFFIX <br /> <br />CITY <br /> <br />STATE TPOSTAL CODE <br /> <br />COUNTRY <br /> <br />13. This FINANCING STATEMENT covers 0 timber to be cut or 0 e.-extracted 16. Additional collateral de.cription: <br />collateralj or is filed as a !XI fixture filing. <br />14. Description of real estate: <br />The goods are or are to become fixtures on: PARCEL 1: <br />The Northwest Quarter (NW1/4) of Section Twenty Four <br />(24), Township Ten (10) North, Range Nine (9) West of <br />the 6th P.M., Hall County, Nebraska excepting a certain <br />tract deeded to The State of Nebraska more particularly <br />described in Warranty Deed recorded in Book 147, Page <br />315; excepting a certain tract more particularly described <br />in Return of Appraiser recorded in Book 14, Page 227; <br />and excepting a certain tract more particularly described <br />in Return of Appraiser recorded in Book 23, Page 494. <br /> <br />(CONTINUED) <br /> <br />, 5. Name and address of 8 RECORD OWNER of above-described real estate <br />(If Debtor doe. not have a record Intere.t): <br /> <br />Fixtures: Cosgriff, Bernard, and Cosgriff, Lola. <br /> <br />17. Check ~ if applicable and check 2!ili. one box. <br /> <br /> <br />Debtor is a 0 Trust or 0 Trustee aeling with respect to property held in trust or D Decadent's Estate <br /> <br /> <br />18. Check ~ if applicable and check 2!ili. one box. <br /> <br />o Debtor is a TRANSMITTING UTILITY <br /> <br /> <br />o Filed in connection with a Manufactured-Home Transaction n effective 30 years <br /> <br /> <br />o Filed in connection with a Public-Finance Transaction -- effective 30 years <br /> <br />FILING OFFICE COPY -- NATIONAL uee FINANCING STATEMENT ADDENDUM (fORM UeelAd)IREV. 07/29/98) <br /> <br />Benker" SVBtt;lms, Inc., St. Cloud, MN Form UCC..1ADD-LAZ 6/30/2001 <br />