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UCC FINANCING STATEMENT ADDENDUM FOllOW INSTRUCTIONS (front and back) CAREFUllY 9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT 9a. ORGANIZATION'S NAME 200609267 OR 9b. INDIVIDUAL'S LAST NAME I FIRST NAME IMIDDLE NAME. SUFFIX PANOWICZ JOHN ALLAN 10.MISCElLANEOUS: THE ABOVE SPACE IS FOR FiliNG OFFICE USE ONLY 11. ADDITIONAL DEBTOR'S EXACT FUll lEGAL NAME - InsertonlyllWl name (lla or llb) - do not abbreviate or combine names lla. ORGANIZATION'S NAME OR 11 b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX llc. MAILING ADDRESS CITY STATE I POSTAL CODE COUNTRY lld. SEE INSTRUCTIONS IADD'L INFO RE 111e. TYPE OF ORGANIZATION llf. JURISDICTION OF ORGANIZATION llg. ORGANIZATIONAL ID #, if any ORGANIZATION I nNONE DEBTOR I I 12. 1 ADDITIONAL SECURED PARTY'S 12l r 1 ASSIGNOR SIP'S NAME - insert only llWl name (12a or 12b) 12a. ORGANIZATION'S NAME OR 12b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 12c. MAILING ADDRESS CITY STATE fOSTAl CODE COUNTRY 13. This FINANCING STATEMENT covers 0 timber to be cut or D as-extracted 16. Additional collateral description: collateral, or is filed as a ~ fixture filing. 14_ Description of real estate~ SWl/4 11-12-12 15. Name and address of a RECORD OWNER of above-described real estete (if Debtor does not have a record interest): 17. Check m ~ applicable and check m one box. Debtor is a n Trust or n Trustee acting with respect to property held in trust or n Decedent's Estate 18. Check m if applicable and check m one box. o Debtor is a TRANSMITTING UTILITY R Filed In connection with a Manufactured.Home Transac~on - effective 30 years Filed in connection with a Public-Finance Transaction - effective 30 years FILING OFFICE COPY - UCC FINANCING STATEMENT ADDENDUM (FORM UGC1Ad) (REV, OS/22/02)