Debtor 1 Case number (if known) First Name Middle Name Last Name ATTACHMENT A: ADDENDUM TO SECTION 4.5 Request for Valuation and Determination of Amount of Secured Claim Motion to Determine Amount of Governmental Unit222s Secured Claim (Attach only if plan includes Class 3 secured claims) 247 4.5: Class 3. Secured claims which the debtor proposes to limit to the value of the collateral by requesting a Collateral (if real property, state address or tax map key; if vehicle, state Vehicle ID No., year, make, model, and mileage. Check if real property is debtor222s principal residence. Debtor222s valuation (specific dollar amount): $ Basis for valuation (e.g., appraisal, broker222s opinion, tax assessment, used car price guide, etc. ) List all security interests 226 in order of seniority 226 in the subject property and which ones are being modified. If the collateral involves more than one account of the same creditor, list each account separately. Check each box below for the specific security interest to be modified. If not modified, the trustee shall make distributions according to the creditor222s proof of claim. To be modified ? Creditor name & last 4 digits of acct Est. balance Amt to be treated as secured if modifi ed Int rat e Est Mo. pmt American LegalNet, Inc. www.FormsWorkFlow.com