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't '. - FINANCING STATEMENT ADDENDUM "- 200 FOLLOW INSTRUCTIONS (front and back) CAREFULLY 9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT 9a, ORGANIZATION'S NAME l' OR TMIDDLE NAME,SUFFIX 9b. INDIVIDUAL'S LAST NAME IFIRST NAME Rodriguez ,- Anacleto .10. MISCELLANEOUS '10590649-NE-557 18490 CARMEL FINANCI " BLWA CFC File with: CC NE Hall County Register of Deeds, NE THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 702921 11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only one name (11a or 11 b) - do not abbreviate or combine names 11a. ORGANIZATION'S NAME OR 11b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 11 c. MAILING ADDRESS CITY STATE TPOSTAL CODE COUNTRY 11d, SEE INSTRUCTION ~D'L INFO RE r 1e, TYPE OF ORGANIZATION 111, JURISDICTION OF ORGANIZATION 11 g. ORGANIZATIONAL ID #, if any RGANIZATION o NONE DEBTOR 12, 0 ADDITIONAL SECURED PARTY'S or 0 ASSIGNOR SIP's NAME - insert only one name (12a or 12b) - - 12a, ORGANIZATION'S NAME OR 12b, INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 12c. MAILING ADDRESS CITY STATE ,POSTAL CODE COUNTRY 13, This FINANCING STATEMENT cevers 0 timber to be cut or 0 as-extracted 16. Additional cellateral description: cellateral or is filed as a [29 fixture filing, 14, Description of real estate; Description: 917 E 7th St Grand Island, NE 68801 County: HALL LAMBERT'S ADD E 54' L T 2 BLK 7 (COMP FR EVANS ADD) Parcel Number: 400058316 Whole House Water Treatment System Model: Hydro Master Serial#243516-611054 The Easterly Fifty Four feet (54') of Fractional Lot Two (2) In Fractional Block Seven (7) In Lambert's Addition and the Westerly Thirty Nine and Six Tenths feet (39.6') of Fractional Lot Two (2). and the Easterly Fourteen and Four Tenths feet (14.4') of Fractional Lot Three (3), In Fractional Block Two (2) of Evans Addition, both beinq Additions to the city of Grand Island, Hall County Nebraska. 15, Name and address of a RECORD OWNER of above-described real estate (if Debtor does not have a recerd interest): 17, Check QO)y if applicable and check QO)y one box. Debtor is aO Trust or 0 Trustee acting with respect to property held in trust or 0 Decedent's Estate 18, Check QO)y if applicable and check QO)y one box o Debtor is a TRANSMITTING UTILITY o Filed in cennection with a Manufactured-Home Transaction -- effective 30 years : n Filed in connection with a Public-Finance Transaction -- effective 30 years - - ;;;;;;;;;; - - ~ - - - - - - - - - ;;;;;;;;;; - = ~ - - - - - - - - - - - ~ FILING OFFICE COPY - NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 05/22/02) Prepared by UCC-DIr.ct Services, Inc" P,O, Box 29071 Glendale, CA 91209-9071 Tel (800) 331-3282