TN FORM UCC1Ap (07/13) Business Services Division Tre Hargett, Secretary of State State of Tennessee INSTRUCTIONS UCC Financing Statement Additional Party (TN Form UCC1Ap) Filing Fee: $15.00 per Debtor added Maximum Principal Indebtedness Tax due upon filing (see instructions) The UCC1Ap (Additional Party) form is 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. 18. FIRST DEBTOR NAME - Insert name of first Debtor shown on Financing Statement to which this Additional Party is related, exactly as shown in item 1 of the UCC1 Financing Statement form. 19 - 21. ADDITIONAL DEBTOR - If this Additional Party form adds an additional Debtor, complete item(s) 19-21 (as needed) in accordance with instruction 1 on the UCC1 Financing Statement form. To add more than one additional Debtor, either use an additional UCC Financing Statement Additional Party form for each additional Debtor or replicate for each additional Debtor the formatting of the UCC1 Financing Statement form 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 UCC1 Financing Statement form), and in either case give complete information for each additional Debtor in accordance with instruction 1 on the UCC1 Financing Statement form. All additional Debtor information, especially the name, must be presented in proper format exactly identical to the format of item 1 of the UCC1 Financing Statement form. 22 - 23. ADDITIONAL SECURED PARTY - If this Additional Party form adds an additional Secured Party, complete item(s) 22-23 (as needed) in accordance with instruction 3 on the UCC1 Financing Statement. In the case of a total assignment of the Secured Party's interest before the filing of this UCC1 Financing Statement, if filer has given the name and address of the Total Assignee in item 3 of the UCC1 Financing Statement, filer may give the Assignor Secured Party's name and address in item(s) 22-23 (as needed). American LegalNet, Inc. www.FormsWorkFlow.com UCC FINANCING STATEMENT ADDITIONAL PARTY FOLLOW INSTRUCTIONS 18. 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 18a. ORGANIZATION'S NAME OR 18b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S) INITIAL(S) SUFFIX THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 19. ADDITIONAL DEBTOR'S NAME: Provide (19a or 19b) only one additional Debtor name (use exact full name; do not omit, modify, or abbreviate any part of the Debtor's name) and enter the mailing address in line 19c 19a. ORGANIZATION'S NAME OR 19b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME CITY ADDITIONAL NAME(S) INITIAL(S) STATE POSTAL CODE SUFFIX COUNTRY 19c. MAILING ADDRESS 20. ADDITIONAL DEBTOR'S NAME: Provide (20a or 20b) only one additional Debtor name (use exact full name; do not omit, modify, or abbreviate any part of the Debtor's name) and enter the mailing address in line 20c 20a. ORGANIZATION'S NAME OR 20b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME CITY ADDITIONAL NAME(S) INITIAL(S) STATE POSTAL CODE SUFFIX COUNTRY 20c. MAILING ADDRESS 21. ADDITIONAL DEBTOR'S NAME: Provide (21a or 21b) only one additional Debtor name (use exact full name; do not omit, modify, or abbreviate any part of the Debtor's name) and enter the mailing address in line 21c 21a. ORGANIZATION'S NAME OR 21b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME CITY ADDITIONAL NAME(S) INITIAL(S) STATE POSTAL CODE SUFFIX COUNTRY 21c. MAILING ADDRESS 22. OR ADDITIONAL SECURED PARTY'S NAME or 22a. ORGANIZATION'S NAME 22b. INDIVIDUAL'S SURNAME ASSIGNOR SECURED PARTY'S NAME: Provide only one name (22a or 22b) FIRST PERSONAL NAME CITY ADDITIONAL NAME(S) INITIAL(S) STATE POSTAL CODE SUFFIX COUNTRY 22c. MAILING ADDRESS 23. ADDITIONAL SECURED PARTY'S NAME or 23a. ORGANIZATION'S NAME OR 23b. INDIVIDUAL'S SURNAME ASSIGNOR SECURED PARTY'S NAME: Provide only one name (23a or 23b) FIRST PERSONAL NAME CITY ADDITIONAL NAME(S) INITIAL(S) STATE POSTAL CODE SUFFIX COUNTRY 23c. MAILING ADDRESS Note: All information on this form is public record. UCC FINANCING STATEMENT ADDITIONAL PARTY (TN FORM UCC1AP) (REV. 07/01/2013) American LegalNet, Inc. www.FormsWorkFlow.com