Collateral Agent
By:
Title:
Authorized Signatory
36
SCHEDULE 5.1
TO PLEDGE AND SECURITY AGREEMENT
GENERAL INFORMATION
(A) Full Legal Name, Type of Organization, Jurisdiction of Organization, Chief
Executive Office/Sole Place of Business and Organizational Identification Number
of each Grantor:
Full Legal Name
Type of
Organization
Jurisdiction of
Organization
Chief Executive
Office/Sole Place of
Business
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 and Corporate Structure within the past year:
Grantor
Date of Change
Description of Change
(D) Agreements pursuant to which any Grantor is bound as debtor within the last
year:
Grantor
Description of Agreement
5.1-1
SCHEDULE 5.2
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
5.2-1
Securities Accounts:
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
II. INTELLECTUAL PROPERTY
(A) Copyrights
Grantor
Description of Copyright
Registration Number
(if any)
Issue Date
(B) Copyright Licenses
Grantor
Description of Copyright
License
Registration Number (if
any) of underlying
Copyright
Name of Licensor
(C) Patents
Grantor
Description of
Patent
Registration
Number
Issue Date
5.2-2
(D) Patent Licenses
Grantor
Description of Patent
License
Registration Number of
underlying Patent
Name of Licensor
(E) Trademarks
Grantor
Description of Trademark
Registration Number
Issue 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
5.2-3
V. WAREHOUSEMAN, BAILEES AND OTHER THIRD PARTIES IN POSSESSION OF COLLATERAL
Grantor
Description of Property
Name and Address of Third Party
VI. TIMBER
Grantor
Location
5.2-4
SCHEDULE 5.4 TO
PLEDGE AND SECURITY AGREEMENT
FINANCING STATEMENTS:
Grantor
Filing Jurisdiction(s)
5.4-1
SCHEDULE 5.5
TO PLEDGE AND SECURITY AGREEMENT
Grantor
Location of Equipment and Inventory
5.5-1
EXHIBIT A
TO PLEDGE AND SECURITY AGREEMENT
PLEDGE SUPPLEMENT
This PLEDGE SUPPLEMENT, dated [mm/dd/yy], is delivered by [NAME OF GRANTOR] a
[NAME OF STATE OF INCORPORATION] [Corporation] (the "Grantor") pursuant to