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<br />.. <br /> <br />. <br /> <br />. <br /> <br />UCC FINANCING STATEMENT ADDENDUM <br />FOllOW INSTRUCTIONS (front and back) CAREFUllY <br />9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT <br />9a, ORGANIZATION'S NAME <br /> <br />OR Third City Christian Church <br />9b, INDIVIDUAL'S lAST NAME <br /> <br />200810094. <br /> <br />I FIRST NAME <br /> <br />I MIDDLE NAME,SUFFIX <br /> <br />10. MISCEllANEOUS: <br /> <br />110, ORGANIZATION'S NAME <br /> <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />'S EXACT FUll lEGAL NAME - insert only one name (11 a or 11 b) - do not abbreviate or combine names <br /> <br />11, ADDITIONAL <br /> <br />OR <br /> <br />lIb, INDIVIDUAL'S lAST NAME <br /> <br />FIRST NAME <br /> <br />MIDDLE NAME <br /> <br />SUFFIX <br /> <br />11 c, MAILING ADDRESS <br /> <br />CITY <br /> <br />STATE rOSTAl CODE <br /> <br /> <br />11 g, ORGANIZATIONAL ID t, if any <br /> <br />COUNTRY <br /> <br />lId, TAX iD #: SSN OR EIN /ADO'l INFO RE 111e. TYPE OF ORGANiZATION <br />ORGANIZATION <br />DEBTOR I <br /> <br />1!f, JURiSDiCTION OF ORGANiZATION <br /> <br />12, ::J ADDITIONAL SECURED PARTY'S or [J ASSIGNOR SIP'S NAME - insert only one name (12a or 12b) <br />12a. ORGANIZATION'S NAME <br /> <br />I <br /> <br />I <br /> <br />D NONE <br /> <br />OR <br /> <br />12b. INDIVIDUAL'S lAST NAME <br /> <br />FIRST NAME <br /> <br />MIDDLE NAME <br /> <br />SUFFIX <br /> <br />12c, MAILING ADDRESS <br /> <br />CITY <br /> <br />STATE rOSTAl CODE <br /> <br />COUNTRY <br /> <br />13, This FINANCING STATEMENT Covers D timber to be cut or D as-extracted <br /> <br /> <br />collateral. or is filed as a !XI fixture filing, <br /> <br /> <br />14. Description of real estate: <br /> <br />LOT I, OF GRAND WEST SUBDIVISION, <br />AN ADDITION TO THE CITY OF GRAND <br />ISLAND, HALL COUNTY, NEBRASKA <br /> <br />1 6. Additional collateral description: <br />and applications for patents, copyrights, trademarks, trade secrets, good <br />will, trade names, customer lists, permits and franchises, payment <br />intangibles, computer programs and all supporting information provided <br />in connection with a transaction relating to computer programs, and the <br />right to use Debtor's name. FIXTURES: All goods now or in the future <br />affixed or attached to real estate. Pledges now or in the future <br /> <br />15, Name and address of a RECORD OWNER of above-described,eal estate <br />(if Debtor does not have a record interest): <br /> <br />FILING OFFICE COpy.. NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV, 07/29/9B) <br /> <br />1 7, Check 2!!h'. if applicable and check 2!!h'. one box, <br /> <br /> <br />Debtor is a 0 Trust or 0 Trustee acting with respect to property held in trust or 0 Decedent's Estate <br /> <br /> <br />18, Check 2!!h'. if applicable and check2!!h'. one box, <br /> <br />D Debto, is a TRANSMITTING UTILITY <br /> <br /> <br />o Filed in connection with a Manufactured-Home Transaction __ effective 30 years <br /> <br /> <br />o Filed in connection with a Public-Finance Transaction -- effective 30 years <br /> <br />Bankers Sy:s.tElms, Inc.. St. Cloud, MN Form UCC-1ADD-LAZ 5/301.2001 <br />