SECRETARY OF THE STATE OF CONNECTICUT MAILING ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, P.O. BOX 150470, HARTFORD, CT 06115-0470 DELIVERY ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, 30 TRINITY STREET, HARTFORD, CT 06106 PHONE: 860-509-6002 WEBSITE: www.concord-sots.ct.gov UCC FINANCING STATEMENT AMENDMENT ADDENDUM USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 81/2 X 11 SHEETS IF NECESSARY. FILING PARTY (CONFIRMATION WILL BE SENT TO THIS ADDRESS): CUSTOMER ID: NAME: ADDRESS: CITY: STATE: EMAIL: 11. INITIAL FINANCING STATEMENT FILE # (SAME AS ITEM 1 ON AMENDMENT FORM) ZIP: 12. NEW OR ADDED INFORMATION: 12A. ORGANIZATION'S NAME OR DEBTOR SECURED PARTY 12B. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME MIDDLE SUFFIX 12C. MAILING ADDRESS: ADDRESS: CITY: STATE: ZIP: DEBTOR COUNTRY: SECURED PARTY 13. NEW OR ADDED INFORMATION: 13A. ORGANIZATION'S NAME OR 13B. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME MIDDLE SUFFIX 13C. MAILING ADDRESS: ADDRESS: CITY: STATE: ZIP: COUNTRY: PAGE 1 OF 2 FORM UMA-1-1.1 Rev. 7/2013 American LegalNet, Inc. www.FormsWorkFlow.com 14. USE THIS SPACE FOR ADDITIONAL INFORMATION PAGE 2 OF 2 FORM UMA-1-1.1 Rev. 7/2013 American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS FOR CONNECTICUT UCC FINANCING STATEMENT AMENDMENT ADDENDUM (FORMUCC3AD) 11. Enter information exactly as given in item 1 on Amendment form. 12. & 13 Select whether a debtor or secured party is being added. 14. If space on Amendment form is sufficient or you must provide additional information, enter additional information in item 14. OFFICE OF THE SECRETARY OF THE STATE MAILING ADDRESS: COMMERCIAL RECORDING DIVISION CONNECTICUT SECRETARY OF THE STATE P.O. BOX 150470 HARTFORD, CT 06115-0470 DELIVERY ADDRESS: COMMERCIAL RECORDING DIVISION CONNECTICUT SECRETARY OF THE STATE 30 TRINITY STREET HARTFORD, CT 06106 PHONE:860-509-6002 WEBSITE: www.concord-sots.ct.gov INSTRUCTIONS DO NOT SCAN THIS PAGE FORM UMA-1-1.1 Rev. 7/2013 American LegalNet, Inc. www.FormsWorkFlow.com