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- .. UCC FINANCING STATEMENT ADDENDUM FOLLOW INSTRUCTIONS Ifront and back) CAREFULLY 9. NAME OF FIRST DEBTOR (1a or 1 b) ON RELATED FINANCING STATEMENT 200509640 9a. ORGANIZATION'S NAME OR Central Nebraska Goodwill Housinl! II. Inc. 9b. INDIVIDUAL'S LAST NAME I FIRST NAME TMIDDLE NAME,SUFFIX 10.MISCELLANEOUS: THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only = name (11. or 11 b) - do not abbreviate or combine names 11.. ORGANIZATION'S NAME OR 11 b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 11c. MAILING ADDRESS CITY STATE I POSTAL CODE COUNTRY 11 d. SEE INSTRUCTIONS lADD'L INFO RE 111e. TYPE OF ORGANIZATION 111. JURISDICTION OF ORGANlZA TION 11 g. ORGANIZATIONAL 10 #, if any ORGANIZA -nON I D NONE DEBTOR I I 12. 1 ADDITIONAL SECURED PARTY'S Ql fl ASSIGNOR SIP'S NAME. insert only one name (12a or 12b) 12.. ORGANIZATION'S NAME OR 12b.INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 12c. MAILING ADDRESS CITY STATE IPOSTALCODE COUNTHY 13. This FINANCING STATEMENT ccvers D timber to be cut or D as--axlracted 16. Additional collateral description: collateral, or is filed as a D fixture filing_ 14. Description of real estate: Lot Three (3), Dowd Subdivision, in the City of Grand Island, Hall County, Nebraska. 15. Name and address of a RECORD OWNER of abov&-described real esteta (if Debtor does not have a record interest): 17. Check 2lili' if applicable and check 2lili' one box. Debtor is a n Trust or n Trustee acting with respect to property neld in trust or n Decedent's Estate 18. Check 2lili' if applicable and check 2lili' one box. = Debtor is a TRANSMITTING UTILITY - Filed in connection with a Manufactured-Home Transaction - effective 30 year5 Filed in connection with a Public-Finance Transaction - effective 30 years FILING OFFICE COpy - UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. OS/22/02)