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UCC FINANCING STATEMENT ADDENDUM State Form 50181 (5-01)Approved by State Board of Accounts, 2001 THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY FOLLOW INSTRUCTIONS (FRONT AND BACK) CAREFULLY. 9a. ORGANIZATION’S NAME 10. MISCELLANEOUS 11. ADDITIONAL DEBTOR’S EXACT FULL LEGAL NAME - Insert only one debtor (11a or 11b) - do not abbreviate or combine names OR 11a. ORGANIZATION’S NAME 11b. INDIVIDUAL’S LAST NAME 11c. MAILING ADDRESS FIRST NAME CITY MIDDLE NAME SUFFIX STATE POSTAL CODE COUNTRY ADD’L INFO RE 11e. TYPE OF ORGANIZATION 11f. JURISDICTION OF ORGANIZATION 11g. ORGANIZATIONAL ID #, if any NONE 12. ADDITIONAL SECURED PARTY’S or ASSIGNOR S/P’S NAME - insert only one secured party name (12a or 12b) OR 12a. ORGANIZATION’S NAME 12b. INDIVIDUAL’S LAST NAME 12c. MAILING ADDRESS FIRST NAME CITY MIDDLE NAME SUFFIX STATE POSTAL CODE COUNTRY 9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT 9b. INDIVIDUAL’S LAST NAME FIRST NAME MIDDLE NAME, SUFFIX OR 13. This FINANCING STATEMENT covers timber to be cut as-extracted collateral, or as a fixture filing. 14. Description of real estate: 16. Additional collateral description: 18. Check only if applicable and check only one box. Debtor is a TRANSMITTING UTILITY Filed in connection with a Manufactured-Home Transaction - effective 30 yearsFiled in connection with a Public-Finance Transaction - effective 30 years 17. Check only if applicable and check only one box. Debtor is a Trust or Trustee acting with respect to property held in trust or Decedent’s Estate 15. Name and address of a RECORD OWNER of above-described real estate FILING OFFICE COPY - INDIANA UCC FINANCING STATEMENT ADDENDUM Instructions for National UCC Financing Statement Addendum (Form UCC1Ad) Insert name of first Debtor shown on Financing Statement to which this Addendum is related, exactly as shown in item 1 of Financing Statement. Miscellaneous: Under certain circumstances, additional information not provided on Financing Statement may be required. Also, some states have 9. 10. 11. 12. 13-15. 16. 17. 18.

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