Fill and Sign the Ucc1ad Financing Statement Addendumtennessee Form

TN FORM UCC1Ad (12 /1/201 6) Business Services Division Tre Hargett, Secretary of State State of Tennessee INSTRUCTIONS UCC Financing Statement Addendum (TN Form UCC1Ad) Filing Fee: See instructions for UCC Financing Statement (TN Form UCC1) Pursuant t o T.C.A. § 3 9 -1 7 -1 1 7 , it is a Class E f elony f or any person t o k now i ngly prepare, sign, or f ile a ny lien or ot her docum ent w it h t he i nt ent t o encum ber any real or personal proper t y w hen such per son has no reasona ble basis o r any legal ca use t o place such lien or encum bra nce on such real or personal pr opert y. A blank form follows these instructions. The UCC1 Ad Financing Statement Addendum must be filed in conjunction with the initial UCC1 Financing S tatement. Please refer to the UCC1 Financing Statement instructions for dir ections on how to submit the forms. Please type or laser -print this form. Be sure it is legible. Read all instructions, espec ially instruction 9; correct Debtor name is crucial. Follow instructions completely. Fill in form very carefully; mistakes may have important legal cons equences. 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. 9. NAME OF FIRST DEBTOR - Insert name of first Debtor shown on UCC Financing Statement (UCC1) to which this Addendum is related, exactly as shown in item 1 of UCC Financing Statement ( UCC1). 10. ADDITIONAL DEBTOR - If this Addendum adds an additional Debtor, complete item 10 in accordance with instruction 1 on UCC Financing Statement (UCC1). To add mor e than one additional Debtor, either use an additional Addendum form for each additional Debtor or replic ate for each additional Debtor the formatting of UCC Financing Statement (UCC1) 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 UCC Financi ng Statement (UCC1)), and in either case give com plete information for each additional Debtor in accordance with instruction 1 on UCC Financing Statement (UCC1). All additional Debtor information, especially th e name, must be presented in proper format exactly identical to the format of item 1 of UCC Financing Statement (UCC1) . 11. ADDITIONAL SECURED PARTY - If this Addendum adds an additional Secured Party, complete item 11 in accordance with instruction 3 on UCC Financing Statement (UCC1). In the case of a total assignment of the Secured Party’s interes t before the filing of this UCC Financing Statement (UCC1) , if filer has given the name and address of the Total Assignee in item 3 of the UCC Financing Statement (UCC1) , filer may give the Assignor Secured Party’s name and address in item 11. 12. ADDITIONAL COLLATERAL - Use this space to provide continued description of collateral, if you cannot complete description in item 4 of UCC Financing Statement (UCC1) . 13, 15 & 16. If collateral is real estate, provide a full legal description of the real e state in item 16. The description of real estate must be sufficient under the applicable law of the jurisdiction where the real estate is located. If Debtor is not a record owner of the described real estat e, also provide, in item 15, the name and address of the record owner. Also provide collateral description in i tem 4 of UCC Financing Statement (UCC1) . C heck box 13 if this UCC Financing Statement (UCC1) is to be filed (for record) (or recorded) in the REAL ESTATE RECORDS (if applicable) . 14. If the UCC Financing Statement (UCC1) covers timber to be cut , as -extracted collateral , or filed as a fixture filing, check the appropriate box in item 14. 17. Miscellaneous - Under certain circumstances, additional information not provided on UCC Financing Statemen t (UCC1) may be required. Also, some states have non -uniform requirements. Use this space to provide such additional information or to comply with such requirements; otherwis e, leave blank. Do not include confidential personal information such as birth dates or social securi ty numbers. 10c. MAILING ADDRESSCITYS TAT EPOSTAL CODE COUNTRY 9. 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 fi t, check here UCC FINANCING STATEMENT ADDENDUM FOLLOW INSTRUCTIONS UCC FINANCING STATEMENT ADDENDUM (TN FORM UCC1Ad) (REV. 12/1/20 16) 9a. ORGANIZATION’S NAME 9b. INDIVIDUAL’S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S) INITIAL(S) SUFFIX 10. DEBTOR’S NAME: Provide (10a or 10b) only one additional Debtor name or Debtor name that did not fi t 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 10a. ORGANIZATION’S NAME 10b. INDIVIDUAL’S SURNAME INDIVIDUAL’S FIRST PERSONAL NAME INDIVIDUAL’S ADDITIONAL NAME(S) INITIAL(S) SUFFIX 11. ADDITIONAL SECURED PARTY’S NAME or ASSIGNOR SECURED PARTY’S NAME: Provide only one name (11a or 11b) OR THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY OR 11a. ORGANIZATION’S NAME 11b. INDIVIDUAL’S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S) INITIAL(S) SUFFIX 11c. MAILING ADDRESS CITYS TAT EPOSTAL CODE COUNTRY 12. ADDITIONAL SPACE FOR ITEM 4 (COLLATERAL): 13. This FINANCING STATEMENT is to be fi led (for record) (or recorded) in the REAL ESTATE RECORDS (If applicable) 14. This FINANCING STATEMENT: covers timber to be cut covers as-extracted collateral is fi led as a fi xture fi ling 15. Name and address of a RECORD OWNER of real estate described in Item 16 (if Debtor does not have a record interest): 16. Description of real estate: 17. MISCELLANEOUS: Note: All information on this form is public record. OR