Jurisdiction of
Organization
Chief Executive
Office/Sole Place of
Business (or
Residence if
Grantor is a
Natural Person)
Organization I.D.#
(B) Other Names (including any Trade Name or Fictitious Business Name) under
which each
Grantor currently conducts business:
Full Legal Name
Trade Name or Fictitious Business Name
(C) Changes in Name, Jurisdiction of Organization, Chief Executive Office or
Sole Place of Business (or Principal Residence if Grantor is a Natural Person)
and Corporate Structure within past five (5) years:
Grantor
Date of Change
Description of Change
(D) Agreements pursuant to which any Grantor is bound as debtor within past five
(5) years:
Grantor
Description of Agreement
A-2
SUPPLEMENT TO SCHEDULE 5.02
TO PLEDGE AND SECURITY AGREEMENT
COLLATERAL IDENTIFICATION
I. INVESTMENT RELATED PROPERTY
(A) Pledged Stock:
Grantor
Stock
Issuer
Class of
Stock
Certificated
(Y/N)
Stock
Certificate
No.
Par Value
No. of
Pledged
Stock
Percentage
of
Outstanding
Stock of the
Stock Issuer
Pledged LLC Interests:
Grantor
Limited
Liability
Company
Certificated
(Y/N)
Certificate No.
(if any)
No. of Pledged
Units
Percentage of
Outstanding
LLC Interests
of the Limited
Liability
Company
Pledged Partnership Interests:
Grantor
Partnership
Type of
Partnership
Interests (e.g.,
general or
limited)
Certificated
(Y/N)
Certificate No.
(if any)
Percentage of
Outstanding
Partnership
Interests of the
Partnership
Pledged Trust Interests:
Grantor
Trust
Class of Trust
Interests
Certificated
(Y/N)
Certificate No.
(if any)
Percentage of
Outstanding
Trust Interests
of the Trust
Pledged Debt:
Grantor
Issuer
Original
Principal
Amount
Outstanding
Principal
Balance
Issue Date
Maturity Date
A-3
Securities Account:
Grantor
Share of Securities
Intermediary
Account Number
Account Name
Deposit Accounts:
Grantor
Name of
Depositary Bank
Account Number
Account Name
Commodities Accounts:
Grantor
Name of Commodities
Intermediary
Account Number
Account Name
(B)
Grantor
Date of Acquisition
Description of Acquisition
II. INTELLECTUAL PROPERTY
(A) Copyrights
Grantor
Description of Copyright
Registration Number
Registration Date
(B) Copyright Licenses
Grantor
Description of
Copyright License
Registration Number
(if any) of underlying
Copyright
Name of Licensor
(C) Patents
Grantor
Title of Patent
Patent Number/
(Application Number)
Issue Date/ (Filing Date)
A-4
(D) Patent Licenses
Grantor
Description of
Patent License
Patent Number of
underlying Patent
Name of Licensor
(E) Trademarks
Grantor
Trademark
Registration Number/
(Serial Number)
Registration Date/
(Filing Date)
(F) Trademark Licenses
Grantor
Description of
Trademark License
Registration Number of
underlying Trademark
Name of Licensor
(G) Trade Secret Licenses
III. COMMERCIAL TORT CLAIMS
Grantor
Commercial Tort Claims
IV. LETTER-OF-CREDIT RIGHTS
Grantor
Description of Letters of Credit
V. WAREHOUSEMAN, BAILEES AND OTHER THIRD PARTIES IN POSSESSION OF COLLATERAL
Grantor
Description of Property
Name and Address of Third Party
VI. MATERIAL CONTRACTS
Grantor
Description of Material Contract
A-5
SUPPLEMENT TO SCHEDULE 5.04
TO PLEDGE AND SECURITY AGREEMENT
Financing Statements:
Grantor
Filing Jurisdiction(s)
A-6
SUPPLEMENT TO SCHEDULE 5.05
TO PLEDGE AND SECURITY AGREEMENT
Additional Information:
Name of Grantor
Location of Equipment and Inventory
A-7
EXHIBIT B
TO PLEDGE AND SECURITY AGREEMENT
UNCERTIFICATED SECURITIES CONTROL AGREEMENT
This Uncertificated Securities Control Agreement dated as of [
],
20[
] among [
] (the "Pledgor"), Goldman Sachs Bank USA, as
collateral agent for