TN FORM UCC1Ad (07/13) Business Services Division Tre Hargett, Secretary of State State of Tennessee INSTRUCTIONS UCC Financing Statement Addendum (TN Form UCC1Ad) Filing Fee: $15.00 per Debtor added Maximum Principal Indebtedness Tax due upon filing (see instructions) The UCC1Ad Financing Statement Addendum must be filed in conjunction with the initial UCC1 Financing Statement. Please refer to the UCC1 Financing Statement instructions for directions on how to submit the forms. Please type or laser-print this form. Be sure it is legible. Read all instructions, especially instruction 9; correct Debtor name is crucial. Follow instructions completely. Fill in form very carefully; mistakes may have important legal consequences. If you have questions, consult your attorney. Filing office cannot give legal advice. Do not insert anything in the open space in the upper right portion or in the right hand vertical margin of this form. It is reserved for filing office use. 9. NAME OF FIRST DEBTOR - Insert name of first Debtor shown on UCC Financing Statement (UCC1) to which this Addendum is related, exactly as shown in item 1 of UCC Financing Statement (UCC1). 10. ADDITIONAL DEBTOR - If this Addendum adds an additional Debtor, complete item 10 in accordance with instruction 1 on UCC Financing Statement (UCC1). To add more than one additional Debtor, either use an additional Addendum form for each additional Debtor or replicate for each additional Debtor the formatting of UCC Financing Statement (UCC1) item 1 on an 8.5 x 11 inch sheet (showing at the top of the sheet the name of the first Debtor shown on the UCC Financing Statement (UCC1)), and in either case give complete information for each additional Debtor in accordance with instruction 1 on UCC Financing Statement (UCC1). All additional Debtor information, especially the name, must be presented in proper format exactly identical to the format of item 1 of UCC Financing Statement (UCC1). 11. ADDITIONAL SECURED PARTY - If this Addendum adds an additional Secured Party, complete item 11 in accordance with instruction 3 on UCC Financing Statement (UCC1). In the case of a total assignment of the Secured Party's interest before the filing of this UCC Financing Statement (UCC1), if filer has given the name and address of the Total Assignee in item 3 of the UCC Financing Statement (UCC1), filer may give the Assignor Secured Party's name and address in item 11. 12. ADDITIONAL COLLATERAL - Use this space to provide continued description of collateral, if you cannot complete description in item 4 of UCC Financing Statement (UCC1). 13, 15 & 16. IF COLLATERAL IS REAL ESTATE - Provide a full legal description of the real estate in item 16. The description of real estate must be sufficient under the applicable law of the jurisdiction where American LegalNet, Inc. www.FormsWorkFlow.com the real estate is located. If Debtor is not a record owner of the described real estate, also provide, in item 15, the name and address of the record owner. Also provide collateral description in item 4 of UCC Financing Statement (UCC1). Check box 13 if this UCC Financing Statement (UCC1) is to be filed (for record) (or recorded) in the REAL ESTATE RECORDS (if applicable). 14. If the UCC Financing Statement (UCC1) covers timber to be cut, as-extracted collateral, or filed as a fixture filing, check the appropriate box in item 14. 17. MISCELLANEOUS - Under certain circumstances, additional information not provided on UCC Financing Statement (UCC1) may be required. Also, some states have non-uniform requirements. Use this space to provide such additional information or to comply with such requirements; otherwise, leave blank. Do not include confidential personal information such as birth dates or social security numbers. American LegalNet, Inc. www.FormsWorkFlow.com UCC FINANCING STATEMENT ADDENDUM FOLLOW INSTRUCTIONS 9. NAME OF FIRST DEBTOR: Same as item 1a or 1b on Financing Statement; If line 1b was left blank because individual Debtor name did not fit, check here 9a. ORGANIZATION'S NAME OR 9b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S) INITIAL(S) SUFFIX THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 10. DEBTOR'S NAME: Provide (10a or 10b) only one additional Debtor name or Debtor name that did not fit in line 1b or 2b of the Financing Statement (Form UCC1) (use exact full name; do not omit, modify, or abbreviate any part of the Debtor's name) and enter the mailing address in line 10c 10a. ORGANIZATION'S NAME OR 10b. INDIVIDUAL'S SURNAME INDIVIDUAL'S FIRST PERSONAL NAME INDIVIDUAL'S ADDITIONAL NAME(S) INITIAL(S) 10c. MAILING ADDRESS 11. OR ADDITIONAL SECURED PARTY'S NAME or 11a. ORGANIZATION'S NAME 11b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME CITY ADDITIONAL NAME(S) INITIAL(S) STATE POSTAL CODE SUFFIX COUNTRY CITY STATE POSTAL CODE SUFFIX COUNTRY ASSIGNOR SECURED PARTY'S NAME: Provide only one name (11a or 11b) 11c. MAILING ADDRESS 12. ADDITIONAL SPACE FOR ITEM 4 (COLLATERAL): 13. This FINANCING STATEMENT is to be filed (for record) (or recorded) in the REAL ESTATE RECORDS (If applicable) 14. This FINANCING STATEMENT: covers timber to be cut covers as-extracted collateral is filed as a fixture filing 15. Name and address of a RECORD OWNER of real estate described in Item 16 (if Debtor does not have a record interest): 16. Description of real estate: 17. MISCELLANEOUS: Note: All information on this form is public record. UCC FINANCING STATEMENT ADDENDUM (TN FORM UCC1Ad) (REV. 07/01/2013) American LegalNet, Inc. www.FormsWorkFlow.com