§ 7-9a-521

(a) Initial financing statement form. A filing office that accepts written records may not refuse to accept a written initial financing statement in the following form and format except for a reason set forth in Section 7-9A-516(b):UCC FINANCING STATEMENTFOLLOW INSTRUCTIONSA. NAME & PHONE OF CONTACT AT FILER (optional) ___________________________________B. E-MAIL CONTACT AT FILER (optional) _________C. SEND ACKNOWLEDGMENT TO: (Name and Address)_________________________________________________THE ABOVE SPACE IS FORFILING OFFICE USE ONLY1. DEBTOR’S NAME: Provide only one Debtor name (1a or 1b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor’s name); if any part of the Individual Debtor’s name will not fit in line 1b, leave all of item 1 blank, check here [ ] and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad)1a. ORGANIZATION’S NAME _________________________________________OR1b. INDIVIDUAL’S SURNAME _________________FIRST PERSONAL NAME ______________ADDITIONAL NAME(S)/INITIAL(S) _______________SUFFIX _________1c.

NIZATION’S NAME _________________________________________OR1b. INDIVIDUAL’S SURNAME _________________FIRST PERSONAL NAME ______________ADDITIONAL NAME(S)/INITIAL(S) _______________SUFFIX _________1c. MAILING ADDRESS ____________________CITY __________STATE _________POSTAL CODE _________COUNTRY _________2. DEBTOR’S NAME: Provide only one Debtor name (2a or 2b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor’s name); if any part of the Individual Debtor’s name will not fit in line 2b, leave all of item 2 blank, check here [ ] and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad)2a. ORGANIZATION’S NAME _________OR2b. INDIVIDUAL’S SURNAME _________FIRST PERSONAL NAME _________ ADDITIONAL NAME(S)/INITIAL(S) ___________________SUFFIX _________2c. MAILING ADDRESS _____________________CITY _________STATE _________POSTAL CODE _________COUNTRY _________3. SECURED PARTY’S NAME (or NAME of ASSIGNEE of ASSIGNOR SECURED PARTY): Provide only one Secured Party name (3a or 3b)3a. ORGANIZATION’S NAME _________OR3b. INDIVIDUAL’S SURNAME _________FIRST PERSONAL NAME _________ADDITIONAL NAME(S)/INITIAL(S)

ASSIGNOR SECURED PARTY): Provide only one Secured Party name (3a or 3b)3a. ORGANIZATION’S NAME _________OR3b. INDIVIDUAL’S SURNAME _________FIRST PERSONAL NAME _________ADDITIONAL NAME(S)/INITIAL(S) _________SUFFIX _________3c. MAILING ADDRESS _________CITY _________STATE _________POSTAL CODE _________COUNTRY _________4. COLLATERAL: This financing statement covers the following collateral: __________________________5. Check only if applicable and check only one box:Collateral is[ ] held in a Trust (see UCC1Ad, Item 17 and Instructions)[ ] being administered by a Decedent’s Personal Representative6a. Check only if applicable and check only one box:[ ] Public-Finance Transaction[ ] Manufactured-Home Transaction[ ] A Debtor is a Transmitting Utility6b. Check only if applicable and check only one box:[ ] Agricultural Lien[ ] Non-UCC Filing7. ALTERNATIVE DESIGNATION (if applicable):[ ] Lessee/Lessor[ ] Consignee/Consignor[ ] Seller/Buyer[ ] Bailee/Bailor [ ] Licensee/Licensor8. OPTIONAL FILER REFERENCE DATA: _________________________________[UCC FINANCING STATEMENT (Form UCC1)]UCC FINANCING STATEMENT ADDENDUMFOLLOW INSTRUCTIONS9.

yer[ ] Bailee/Bailor [ ] Licensee/Licensor8. OPTIONAL FILER REFERENCE DATA: _________________________________[UCC FINANCING STATEMENT (Form UCC1)]UCC FINANCING STATEMENT ADDENDUMFOLLOW INSTRUCTIONS9. 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 fit, check here [ ]9a. ORGANIZATION’S NAME _________OR9b. INDIVIDUAL’S SURNAME _________FIRST PERSONAL NAME _________ADDITIONAL NAME(S)/INITIAL(S) _________SUFFIX _________THE ABOVE SPACE IS FORFILING OFFICE USE ONLY10. 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 10c10a. ORGANIZATION’S NAME _________OR10b. INDIVIDUAL’S SURNAME _________FIRST PERSONAL NAME _________ADDITIONAL NAME(S)/INITIAL(S) _________SUFFIX _________10c. MAILING ADDRESS _________CITY _________STATE _________POSTAL CODE _________COUNTRY _________11. [ ] ADDITIONAL SECURED PARTY’S NAME or [ ] ASSIGNOR SECURED PARTY’S NAME: Provide only one name (11a or

MAILING ADDRESS _________CITY _________STATE _________POSTAL CODE _________COUNTRY _________11. [ ] ADDITIONAL SECURED PARTY’S NAME or [ ] ASSIGNOR SECURED PARTY’S NAME: Provide only one name (11a or 11b)11a. ORGANIZATION’S NAME _________OR11b. INDIVIDUAL’S SURNAME _________FIRST PERSONAL NAME _________ADDITIONAL NAME(S)/INITIAL(S) _________SUFFIX _________11c. MAILING ADDRESS _________CITY _________STATE _________POSTAL CODE _________COUNTRY _________12. ADDITIONAL SPACE FOR ITEM 4 (Collateral) ________________________________13. [ ] This FINANCING STATEMENT is to be filed [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 filed as a fixture filing15. 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: _________(b) Amendment form. A filing office that accepts written records may not refuse to accept a written record in the following form and format except for a reason set forth in Section 7-9A-516(b):UCC FINANCING STATEMENT

m. A filing office that accepts written records may not refuse to accept a written record in the following form and format except for a reason set forth in Section 7-9A-516(b):UCC FINANCING STATEMENT AMENDMENTFOLLOW INSTRUCTIONSA. NAME & PHONE OF CONTACT AT FILER (optional) _________B. E-MAIL CONTACT AT FILER (optional)C. SEND ACKNOWLEDGMENT TO: (Name and Address) _______________________THE ABOVE SPACE IS FORFILING OFFICE USE ONLY1a. INITIAL FINANCING STATEMENT FILE NUMBER _________1b. [ ] This FINANCING STATEMENT AMENDMENT is to be filed [for record] (or recorded) in the REAL ESTATE RECORDSFiler: attach Amendment Addendum (Form UCC3Ad) and provide Debtor’s name in item 13.2. [ ] TERMINATION: Effectiveness of the Financing Statement identified above is terminated with respect to the security interest(s) of Secured Party authorizing this Termination Statement3. [ ] ASSIGNMENT (full or partial): Provide name of Assignee in item 7a or 7b, and address of Assignee in item 7c and name of Assignor in item 9 For partial assignment, complete items 7 and 9 and also indicate affected collateral in item 84.

e name of Assignee in item 7a or 7b, and address of Assignee in item 7c and name of Assignor in item 9 For partial assignment, complete items 7 and 9 and also indicate affected collateral in item 84. [ ] CONTINUATION: Effectiveness of the Financing Statement identified above with respect to the security interest(s) of Secured Party authorizing this Continuation Statement is continued for the additional period provided by applicable law5. [ ] PARTY INFORMATION CHANGE:Check one of these two boxes:This Change affects[ ] Debtor or[ ] Secured Party of record.ANDCheck one of these three boxes to:[ ] CHANGE name and/or address: Complete item 6a or 6b; and item 7a or 7b and item 7c[ ] ADD name: Complete item 7a or 7b, and item 7c[ ] DELETE name: Give record name to be deleted in item 6a or 6b6. CURRENT RECORD INFORMATION: Complete for Party Information Change - provide only one name (6a or 6b)6a. ORGANIZATION’S NAME _________OR6b. INDIVIDUAL’S SURNAME _________FIRST PERSONAL NAME _________ADDITIONAL NAME(S)/INITIAL(S) _________SUFFIX _________7. CHANGED OR ADDED INFORMATION: Complete for Assignment or Party Information Change - provide only one name (7a or 7b) (use exact full name; do not

TIONAL NAME(S)/INITIAL(S) _________SUFFIX _________7. CHANGED OR ADDED INFORMATION: Complete for Assignment or Party Information Change - provide only one name (7a or 7b) (use exact full name; do not omit, modify, or abbreviate any part of the Debtor’s name)7a. ORGANIZATION’S NAME _________OR7b. INDIVIDUAL’S SURNAME _________FIRST PERSONAL NAME _________ADDITIONAL NAME(S)/INITIAL(S) _________SUFFIX __________7c. MAILING ADDRESS _________CITY _________STATE _________POSTAL CODE _________COUNTRY _________8. [ ] COLLATERAL CHANGE:Also check one of these four boxes:[ ] ADD collateral [ ] DELETE collateral [ ] RESTATE covered collateral[ ] ASSIGN collateralIndicate collateral:9. NAME OF SECURED PARTY OF RECORD AUTHORIZING THIS AMENDMENT: Provide only one name (9a or 9b) (name of Assignor, if this is an Assignment)If this is an Amendment authorized by a DEBTOR, check here [ ] and provide name of authorizing Debtor9a. ORGANIZATION’S NAME _________OR9b. INDIVIDUAL’S SURNAME _________FIRST PERSONAL NAME _________ADDITIONAL NAME(S)/INITIAL(S) _________SUFFIX _________10. OPTIONAL FILER REFERENCE DATA: _________[UCC FINANCING STATEMENT AMENDMENT (Form UCC3)]UCC FINANCING STATEMENT AMENDMENT

SONAL NAME _________ADDITIONAL NAME(S)/INITIAL(S) _________SUFFIX _________10. OPTIONAL FILER REFERENCE DATA: _________[UCC FINANCING STATEMENT AMENDMENT (Form UCC3)]UCC FINANCING STATEMENT AMENDMENT ADDENDUMFOLLOW INSTRUCTIONS 11. INITIAL FINANCING STATEMENT FILE NUMBER: Same as item 1a on Amendment form _________12. NAME OF PARTY AUTHORIZING THIS AMENDMENT: Same as item 9 on Amendment form _________12a. ORGANIZATION’S NAME _________OR12b. INDIVIDUAL’S SURNAME _________FIRST PERSONAL NAME _________ADDITIONAL NAME(S)/INITIAL(S) _________SUFFIX _________THE ABOVE SPACE IS FORFILING OFFICE USE ONLY13. Name of DEBTOR on related financing statement (Name of a current Debtor of record required for indexing purposes only in some filing offices - see Instruction item 13): Provide only one Debtor name (13a or 13b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor’s name); see Instructions if name does not fit13a. ORGANIZATION’S NAME _________OR13b. INDIVIDUAL’S SURNAME _________FIRST PERSONAL NAME _________ADDITIONAL NAME(S)/INITIAL(S) _________SUFFIX ______________14. ADDITIONAL SPACE FOR ITEM 8 (Collateral): _________15.

NAME _________OR13b. INDIVIDUAL’S SURNAME _________FIRST PERSONAL NAME _________ADDITIONAL NAME(S)/INITIAL(S) _________SUFFIX ______________14. ADDITIONAL SPACE FOR ITEM 8 (Collateral): _________15. This FINANCING STATEMENT AMENDMENT:[ ] covers timber to be cut[ ] covers as-extracted collateral[ ] is filed as a fixture filing16. Name and address of a RECORD OWNER of real estate described in item 17 (if Debtor does not have a record interest):_________17. Description of real estate: _________18. MISCELLANEOUS: _________[UCC FINANCING STATEMENT AMENDMENT ADDENDUM (Form UCC3Ad)](Act 2001-481, p. 647, §1; Act 2014-374, p. 1339, §1.)