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Fill and Sign the Indiana Ucc1 Financing Statement Addendum Indiana Form

Fill and Sign the Indiana Ucc1 Financing Statement Addendum Indiana Form

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UCC FINANCING STATEMENT ADDENDUM FOLLOW INSTRUCTIONS (front and back) CAREFULLY 9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT O R 9a. ORGANIZATION’S NAME       9b. INDIVIDUAL’S LAST NAME       FIRST NAME       MIDDLE NAME, SUFFIX       10. MISCELLANEOUS:       THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 11. ADDITIONAL DEBTOR’S EXACT FULL LEGAL NAME – insert only one name (11a or 11b) – do not abbreviate or combine names OR 11a. ORGANIZATION’S NAME       11b. INDIVIDUAL’S LAST NAME       FIRST NAME       MIDDLE NAME       SUFFIX       11c. MAILING ADDRESS       CITY       STATE     POSTAL CODE       COUNTRY       11d. SEE INSTRUCTIONS       ADD’L INFO RE ORGANIZATION DEBTOR 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 name (12a or 12b) OR 12a. ORGANIZATION’S NAME       12b. INDIVIDUAL’S LAST NAME       FIRST NAME       MIDDLE NAME       SUFFIX       12c. MAILING ADDRESS       CITY       STATE     POSTAL CODE       COUNTRY       13. This FINANCING STATEMENT covers timber to be cut or as-extracted collateral, or is filed as a fixture filing. 14. Descri ption of real estate:       15. Name and address of a RECORD OWNER of above-described real estate (if Debtor does not have a record interest):       16. Additional collateral description:       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 18. Check only if applicable and check only one box. Debtor is a TRANSMITTING UTILITY Files in connection with a Manufactured-Home Transaction – effective 30 years Filed in connection with a Public-Finance Transaction – effective 30 years FILING OFFICE COPY – UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 05/22/02) Instructions for National UCC Financing Statement Addendum (Form UCC1Ad) 9. Insert name of first Debtor shown on Financing Statement to which this Addendum is related, exactly as shown in item 1 of Financing Statement. 10. Miscellaneous: Under certain circumstances, additional information not provided on Financing Statement 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. 11. If this Addendum adds an additional Debtor, complete item 11 in accordance with Instruction 1 on Financing Statement. To add further additional Debtors, attach either an additional Addendum (Form UCC1Ad) or Additional Party (Form UCC1AP) and follow Instruction 1 of Financing Statement for determining and formatting additional names. 12. If this Addendum adds an additional Secured Party, complete item 12 in accordance with Instruction 3 on Financing Statement. To include further additional Secured Parties, attach either an additional Addendum (Form UCC1Ad) or Additional Party (Form UCC1AP) and follow Instruction 1 of Financing Statement for determining and formatting additional names. In the case of a total assignment of the Secured Party’s interest before the filing of this Financing Statement, if filer has given the name and address of the Total Assignee in item 3 of the Financing Statement, filer may give the Assignor S/P’s name and address in item 12. 13-15. If collateral is timber to be cut or as-extracted collateral, or if this Financing Statement is filed as a fixture filing, check appropriate box in item 13; provide description of real estate in item 14; and, if Debtor is not a record owner of the described real estate, also provide, in item 15, the name and address of a record owner. Also provide collateral description in item 4 of Financing Statement. Also check box 6 on Financing Statement. Description of real estate must be sufficient under the applicable law of the jurisdiction where the real estate is located. 16. Use this space to provide continued description of collateral, if you cannot complete description in item 4 of Financing Statement. 17. If Debtor is a trust or a trustee acting with respect to property held in trust or is a decedent’s estate, check the appropriate box. 18. If Debtor is a transmitting utility or if the Financing Statement relates to a Manufactured-Home Transaction or a Public-Finance Transaction as defined in the applicable Commercial Code, check the appropriate box.

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