Free Financing Statement Addendum - Connecticut

STATE OF CONNECTICUT UCC FINANCING STATEMENT ADDENDUM
FOLLOW INSTRUCTIONS CAREFULLY
7. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT 7a. ORGANIZATION'S NAME OR 7b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME, SUFFIX

8.

THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME ­ insert only one debtor name (8a or 8b) ­ do not abbreviate or combine names 8a. ORGANIZATION'S NAME

OR 8b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX

MAILING ADDRESS 8c ADD'L INFO RE 8d. TYPE OF ORGANIZATION

CITY

STATE

POSTAL CODE

COUNTRY

8e. JURISDICTION OF ORGANIZATION

8f. ORGANIZATIONAL ID # (OPTIONAL)

ORGANIZATION DEBTOR 9. ADDITIONAL SECURED PARTY'S or 9a. ORGANIZATION'S NAME OR 9b. INDIVIDUAL'S LAST NAME

ASSIGNOR S/P'S NAME - insert only one name (9a or 9b)

FIRST NAME

MIDDLE NAME

SUFFIX

9c

MAILING ADDRESS

CITY

STATE

POSTAL CODE

COUNTRY

10.

Additional collateral description:

11.

Check only if applicable. Check only one box. Debtor is: Trust Trustee acting with respect to property held in trust Decedent's Estate

12.

Check only if applicable Debtor is a TRANSMITTING UTILITY Filed in connection with Public Finance Transaction

FILING OFFICE COPY ­ CONNECTICUT UCC FINANCING STATEMENT ADDENDUM (FORM UCC1 Ad) (REV. 07/14/2004)

Instructions for Connecticut UCC Financing Statement Addendum (Form UCC1Ad)
7. 8. Insert name of first Debtor shown on Financing Statement to which this Addendum is related, exactly as shown in item 1 of Financing Statement. If this Addendum adds an additional Debtor, complete item 8 in accordance with Instruction 1 on Financing Statement. To add more than one additional Debtor, either use an additional Addendum form for each additional Debtor or replicate for each additional Debtor the formatting of Financing Statement item 1 on an 8 ½ x11 sheet (showing at the top of the sheet the name of the first Debtor shown on the Financing Statement), and in either case give complete information for each additional Debtor in accordance with Instruction 1 on Financing Statement. All additional Debtor information, especially the name, must be presented in proper format exactly identical to the format of item 1 of Financing Statement. If this Addendum adds an additional Secured Party, complete item 9 in accordance with Instruction 3 on Financing Statement. 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 9. Use this space to provide continued description of collateral, if you cannot complete description in item 4 of Financing Statement. 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. If Debtor is a transmitting utility, check the appropriate box. If filed in connection with a public finance transaction, check the appropriate box.

9.

10. 11. 12.