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<br />UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS (front and backiOAREFULL Y <br />9. NAME OF FIRST DEBTOR (1aor 1b) ON RELATEClFINANCING STATEMENT <br />9.. ORGANIZATION'S NAME <br /> <br />200804839 <br /> <br />OR,.-----,-_ <br />ilb.INDIVIDUAl'SLAST NAME <br />PANOWICZ <br /> <br />10, MISCELLANEOUS; <br /> <br />IFIRSl'NAME'........__.,..._..,.".........TMiDi3LENAM.E~SijFFix <br />I MICHAEL I <br /> <br />THE A.SOVE SPACE IS FOR FILING OFFICE USE ONL Y <br /> <br />11. ADDITIONAL DEBTO~'SEXACT FULL LEGAL NArtE. in.ertonly llJlllnome (11a or11b). do not ebbr...;ale <:.< combin. names <br />11 a. ORGANIZATION'S NAME <br /> <br />OR 11 b. INDIVIDUAl.'S lAST NAME <br /> <br />FIRST NAME <br /> <br />MIDD'!.E NAME <br /> <br />SUFFIX <br /> <br />110- MAIUNG ADDRESS <br /> <br />CITY <br /> <br />STATE POSTAL CODE <br /> <br />COu..iTRY <br /> <br />11d. SEEINSTRUCTIONS <br /> <br /> <br />11 f.JURloiDICTION OF ORGANIZATION <br /> <br />119. ORGANIZATIONAllD #, if any <br /> <br />12. <br /> <br />ASSIGNOR SIP'S <br /> <br /> <br />NONE <br /> <br />OR 121>. INDIVlOUAI.'S lAST NAME <br /> <br />FIRST NAME <br /> <br />MIDDLE NAME <br /> <br />SUFFIX <br /> <br />1k MAIUNG ADDRESS <br /> <br />CITY <br /> <br />.sTATE..... POsrA['coDE-...............m.. COU\iTRY- <br /> <br />13. This FINANCING 5T A TEMENT covens <br />collateral,or;s liled asa l8] IIXllJr. filing. <br />14. De.scription 0.1 teal estate: <br /> <br /> <br />a..extrac!6d 16. Additional cola,",al description: <br /> <br />SE 1/4 SEC. 22 T-12N R-11W &, S 1/2 OF SW 1/4 SEC. 11 T- <br />12N, R-11W HALL COUNTY, NE <br /> <br />15. Name end addle" of a RECORD OWNER 01 ebO\l&-desc,ibed real eelate <br />(if DelllOf does not ~ave " recorQ inlUeell: <br /> <br />MICHAEL A. PANOWICZ <br />PATRICIA M. PANOWICZ <br /> <br />17. C~eck ~ If applicable end oheck i:>M one box. <br />Debtor IS a Truetee acbng wi'" r"'-'poct to property hold In trust or Deeedent's Est"'" <br />18. CI'ock ~ II applicable and ohock~' ona bOll. <br />O~llIorls a TRANSMITTING lmuw <br />Filed in conneotion wi'" a Manufactured-Home Transaotion .- effective 30 yea.. <br />Fill'd in connBotion wi'" a Publlo-Finanoe Tran.action - effoGtive 30 yea,s <br /> <br />FILING OFFICE C.OF'Y - UCC FINANCING STATEMENT ADDENDUM (FORM UCC1A~) (REV. 05122102) <br />