Fill and Sign the Public Counter Monday Friday 830 Am to 430 Pm Form

State of Rhode Island and Providence Plantations Department of State - Business Services Division 148 W. River Street, Providence, Rhode Island 02904-2615 Phone: (401) 222-3040 | Email: corporations@sos.ri.gov | Website: www.sos.ri.gov Hours for filing: Public Counter: Monday – Friday 8:30 AM to 4:30 PM Online filing – 24/7 Information Requests: Information on specific filings of record with this office will not be given over the Telephone; only general information will be available. UCC11 Information Requests cannot be ordered over the telephone. All filings must be communicated in writing. Filing Fees: Filings must be communicated in writing and will not be accepted unless \ accompanied by the minimum filing fee. Checks are to be made payable to the Rhode Island Department of State. We accept VISA, MasterCard, Discover, and American Express for all over-the-counter and online transactions. A small enhanced access fee is charged for all credit card transactions. S\ ee our website for more information on enhanced access fees. Refunds: Refunds will be issued for duplicate payments and rejected documents not\ corrected within 30-days from the date the filing was submitted to this office. Refunds will not be issued for valid transactions and overpayments in th\ e amount of $10 or less. Enhanced access fees are not refundable. To request a refund or view our refund policy click here. Paper Filing Forms:The IACA National Filing Forms will be accepted for filing. Rhode Island does provide a state form for UCC11 Information Requests. Please carefully read all instructions prior to filing. Acknowledgments: Acknowledgements are no longer being mailed. If you would like to receive an Acknowledgement of your fling, you MUST provide a valid email address. Complete ITEM C of the filing form to include a valid email address. E-acknowledgements for all approved filings are emailed at 3pm and 8pm daily. Filing Evidence : If you do not receive an Acknowledgement or if you would like to obtain a copy of any recorded UCC, follow these steps: • Go to our UCC Database • To search for a UCC1 – you must search by debtor name • To search for a UCC3 – you can search by file number or debtor name • Click on the filing number to view the filing summary page • Click on the PDF link to view and print the filing Rejected Filings : Paper filers will receive their filing and payment via US mail addressed to the individual/entity that submitted the paperwork. Correspondence will accompany the paperwork indicating what steps need to be taken to correct the filling. You may also use our Rejected Filing Viewer to view the rejected document. • To search for a UCC1 – you must search by debtor name • To search for a UCC3 – you must search by file number Uniform Commercial Code (UCC) Filing Information UCC Filing Information - Revised: 11/2017 FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (Form UCC1Ad) (Rev. 04/20/11) THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 11. ADDITIONAL SECURED PARTY'S NAME or ASSIGNOR SECURED PARTY'S NAME: Provide only one name (11a or 11b) 12. ADDITIONAL SPACE FOR ITEM 4 (Collateral) : OR UCC FINANCING STATEMENT ADDENDUM FOLLOW INSTRUCTIONS 9. NAME OF FIRST DEBTOR: Same as line 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 9b. INDIVIDUAL'S SURNAME ADDITIONAL NAME(S)/INITIAL(S) FIRST PERSONAL NAME 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 OR 10a. ORGANIZATION'S NAME 10b. INDIVIDUAL'S SURNAME OR 11b. INDIVIDUAL'S SURNAMEFIRST PERSONAL NAME POSTAL CODE 11c. MAILING ADDRESS CITYADDITIONAL NAME(S)/INITIAL(S) STATESUFFIX COUNTRY 11a. ORGANIZATION'S NAME 17. MISCELLANEOUS: SUFFIX 16. Description of real estate: POSTAL CODE CITY 10c. MAILING ADDRESSINDIVIDUAL’S FIRST PERSONAL NAME INDIVIDUAL’S ADDITIONAL NAME(S)/INITIAL(S) STATESUFFIX COUNTRY 15. Name and address of a RECORD OWNER of real estate described in item 16 (if Debtor does not have a record interest): 14. This FINANCING STATEMENT: covers timber to be cut covers as-extracted collateral This FINANCING STATEMENT is to be filed [for record] (or recorded) in the REAL ESTATE RECORDS (if applicable) 13. is filed as a fixture filing Instructions for UCC Financing Statement Addendum (Form UCC1Ad) Please type or laser-print this form. Be sure it is completely legible. Read and follow all Instructions; use of the correct name for the Debtor is crucial. Fill in form very carefully; mistakes may have important legal consequences. If you have questions, consult your attorney. The filing office cannot give legal advice. ITEM INSTRUCTIONS 9.Name of first Debtor. Enter name of first Debtor exactly as shown in item 1 of Financing Statement (Form UCC1) to which this Addendum relates. The name will not be indexed as a separate debtor. The Debtor name in this section is intended to cross-reference this Addendum with the related Financing Statement (Form UCC1). If the box in item 1 of the Financing Statement (Form UCC1) was checked because Individual Debtor name did not fit, the box in item 9 of this Addendum should be checked. 10.Additional Debtor’s name. If this Addendum adds an additional Debtor, complete item 10 in accordance with Instruction 1 of Financing Statement (Form UCC1). For additional Debtors, attach either an additional Addendum or Additional Party (Form UCC1AP) and follow Instruction 1 of Financing Statement (Form UCC1) for determining and formatting additional names. 11.Additional Secured Party’s name or Assignor Secured Party’s name. If this Addendum adds an additional Secured Party, complete item 11 in accordance with Instruction 3 of Financing Statement (Form UCC1). For additional Secured Parties, attach either an additional Addendum or Additional Party (Form UCC1AP) and complete applicable items in accordance with Instruction 3 of Financing Statement (Form UCC1). In the case of a full assignment of the Secured Party’s interest before the filing of this financing statement, if filer has provided the name and mailing address of the Assignee in item 3 of Financing Statement (Form UCC1), filer may enter Assignor Secured Party’s name and mailing address in item 11. 12.Additional Collateral Description. If space in item 4 of Financing Statement (Form UCC1) is insufficient or additional information must be provided, enter additional information in item 12 or attach additional page(s) and incorporate by reference in item 12 (e.g., See Exhibit A). Do not include social security numbers or other personally identifiable information. 13-16.Real Estate Record Information. If this Financing Statement is to be filed in the real estate records and covers timber to be cut, covers as- extracted collateral, and/or is filed as a fixture filing, complete items 1-4 of the Financing Statement (Form UCC1), check the box in item 13, check the appropriate box in item 14, and complete the required information in items 15 and 16. If the Debtor does not have an interest of record, enter the name and address of the record owner in item 15. Provide a sufficient description of real estate in accordance with the applicable law of the jurisdiction where the real estate is located in item 16. If space in items 15 or 16 is insufficient, attach additional page(s) and incorporate by reference in items 15 or 16 (e.g., See Exhibit A), and continue the real estate record information. Do not include social security numbers or other personally identifiable information. 17.Miscellaneous. Under certain circumstances, additional information not provided on the Financing Statement (Form UCC1) may be required. Also, some states have non-uniform requirements. Use this space or attach additional page(s) and incorporate by reference in item 17 (e.g., See Exhibit A) to provide such additional information or to comply with such requirements; otherwise, leave blank. Do not include social security numbers or other personally identifiable information.