TN FORM UCC3Ap (07/13) Business Services Division Tre Hargett, Secretary of State State of Tennessee INSTRUCTIONS UCC Financing Statement AMENDMENT Additional Party (TN Form UCC3Ap) Filing Fee: See UCC3 Financing Statement Amendment Instructions The UCC3 Financing Statement Additional Party must be filed in conjunction with a UCC3 Financing Statement. Please refer to the UCC3 Financing Statement Amendment 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 instructions 2123; 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. 19. INITIAL FINANCING STATEMENT FILE NUMBER - Enter information exactly as given in item 1a of the UCC3 Amendment form. 20. AUTHORIZING PARTY - Enter information exactly as given in item 9 of the UCC3 Amendment (UCC3Ad) form. 21 - 23. DEBTOR NAME - If the UCC3 Amendment is to be filed or recorded in the real estate records, check box 1b of the UCC3 Amendment. Also, in item 13 of the UCC3 Amendment Addendum, enter Debtor's name, in proper format exactly identical to the format of item 1 of Financing Statement, and enter the name of the record owner in item 16 if Debtor does not have a record interest. 24 - 25. ADDITIONAL SECURED PARTY NAME - Enter information for additional Secured Party or Total Assignee, determined and formatted per instruction 1 (TN Form UCC1). American LegalNet, Inc. www.FormsWorkFlow.com UCC FINANCING STATEMENT AMENDMENT ADDITIONAL PARTY FOLLOW INSTRUCTIONS 19. INITIAL FINANCING STATEMENT FILE NUMBER: Same as item 1a on Amendment form 20. NAME OF PARTY AUTHORIZING THIS AMENDMENT: Same as item 9 on Amendment form 20a. ORGANIZATION'S NAME 20b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S) INITIAL(S) SUFFIX THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 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. ADDITIONAL DEBTOR'S NAME: Provide (22a or 22b) 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 22c 22a. ORGANIZATION'S NAME OR 22b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME CITY ADDITIONAL NAME(S) INITIAL(S) STATE POSTAL CODE SUFFIX COUNTRY 22c. MAILING ADDRESS 23. ADDITIONAL DEBTOR'S NAME: Provide (23a or 23b) 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 23c 23a. ORGANIZATION'S NAME OR 23b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME CITY ADDITIONAL NAME(S) INITIAL(S) STATE POSTAL CODE SUFFIX COUNTRY 23c. MAILING ADDRESS 24. OR ADDITIONAL SECURED PARTY'S NAME or 24a. ORGANIZATION'S NAME 24b. INDIVIDUAL'S SURNAME TOTAL ASSIGNEE SECURED PARTY'S NAME: Provide only one name (24a or 24b) FIRST PERSONAL NAME CITY ADDITIONAL NAME(S) INITIAL(S) STATE POSTAL CODE SUFFIX COUNTRY 24c. MAILING ADDRESS 25. ADDITIONAL SECURED PARTY'S NAME or 25a. ORGANIZATION'S NAME TOTAL ASSIGNEE SECURED PARTY'S NAME: Provide only one name (25a or 25b) OR 25b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME CITY ADDITIONAL NAME(S) INITIAL(S) STATE POSTAL CODE SUFFIX COUNTRY 25c. MAILING ADDRESS Note: All information on this form is public record. UCC FINANCING STATEMENT AMENDMENT ADDITIONAL PARTY (TN FORM UCC3AP) (REV. 07/01/2013) American LegalNet, Inc. www.FormsWorkFlow.com