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<br />~." - ; <br /> <br />" , <br /> <br />...c' "'"'.' <br /> <br />~ <br /> <br />UCC FINANCING STATEMENT ADDENDUM <br /> <br />FOLLOW INSTRUCTIONS front and back CAREFULLY <br />9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT <br />9a. ORGANIZATION'S NAM!O <br /> <br />200603208 <br /> <br />OR DOUBLE H PARTNERSHIP <br />9b, INOIVIDUAL'S lAST NAM!O FIRST NAME <br /> <br />MIDDLE NAME,SUFFIX <br /> <br />10.MISCELLANEOUS: <br /> <br />RYAN HAPPOLD BY:)( <br /> <br /> <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br /> <br />11. ADDITIONAL DEBTOR'S EXACT FUL <br /> <br /> lla, ORGANIZATION'S NAME <br />OR 11 b. INDIVIDUAL'S lAST NAME FIRST NAME MIDDLE NAME SUFFIX <br /> HAPPOLD RYAN <br />11 c. MAILING ADDRESS CITY ;;; r~;T~~;DE COUNTRY <br /> 207 EAST PINE DONIPHAN USA <br />11d. SEE INSTRUCTIONS I fDD'L INFO RE 111 e. TYPE OF ORGANIZATION 111. JURISDICTION OF ORGANIZATION 119. ORGANIZATIONAL 10 #, If any <br /> 507113096 ORGANIZATION I I 111 NONE <br /> DEBTOR I <br />12. l ADDITIONAL SECURED PARTY'S Q[ 11 ASSIGNOR SIP'S NAME - ;Mort only = nome (12a or 12b) <br /> 12a. ORGANI2ATION'S NAME <br />OR 12b. INDIVIDUAL'S lAST NAME FIRST NAME MIDDLE NAME <br /> SUFFIX <br />120, MAILING ADDRESS CITY STATE I POSTAL CODE COUNTRY <br />13, This FINANCING STATEMENT covers D limber to be out or IT as-oxtracled 16. Additional collateral desc;tiption" <br /> c;ollatera,l, or is. filed as a IZI fixture filing. <br />14. De5t;.ript1on of rl!lal estate: <br />SW 1/4 SECTION 3 . T 9 N . R 9 W <br />I~LLCOUNTY,NEBRASKA <br />15. Nilme and address of a RECORD OWNER of ii1bovl!!-described real estatl!! <br /> (it Debtor does not hcNE! ~ tecord interest) <br />GARY BOLTZ 17. Check wl:i if applicable and chock wl:i one box. <br />KAY BOCKMAN Ol!!lbtor is a n Trust or n Trustee acting with respl!!ct to property held in trust or n Decedent's Estate <br />DONNA ROACH 18. Cho<k wl:i ilopplicoblo ond check wl:i OM box. <br /> a Dobler IS a TRANSMITTING UTILITY <br />HALL COUNTY, NE LEASE #3435 Filed in oonnection with a Manufa4;tured-Home Tran5action - effeotive 30 years <br />n Filed in connectIon with a Public-Finance Transaction ~ effec;;tive 30 years <br /> . . <br /> <br />International Association of Commercial Administrators (IACA) <br />FiliNG OFFICE COpy - UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. OS/22/02) <br />