No. of
Pledged
Stock
Percentage
of
Outstanding
Stock of the
Stock Issuer
(B)
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
(C)
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
(D)
Trust Interests or other Equity Interests not listed above:
Grantor
Trust
Class of
Trust
Interests
Certificated
(Y/N)
Certificate
No.
(if any)
Percentage
of
Outstanding
Trust
Interests of
the Trust
EXHIBIT A-3
(E)
Pledged Debt:
Grantor
Issuer
Original
Principal
Amount
Outstanding
Principal
Balance
Issue Date
Maturity
Date
(F)
Securities Account:
Grantor
Share of Securities
Intermediary
Account Number
Account Name
(G)
Deposit Accounts:
Grantor
Name of Depositary
Bank
Account Number
Account Name
(H)
Commodity Contracts and Commodity Accounts:
Grantor
Name of Commodity
Intermediary
Account Number
Account Name
II.
INTELLECTUAL PROPERTY
(A)
Copyrights
Grantor
Jurisdiction
Title of Work
Registration
Number (if any)
Registration
Date (if any)
(B)
Copyright Licenses
Grantor
Description of
Copyright License
Registration
Number (if any) of
underlying
Copyright
Name of Licensor
(C)
Patents
EXHIBIT A-4
Grantor
Jurisdiction
Title of Patent
Patent
Number/(Application
Number)
Issue
Date/(Filing
Date)
(D)
Patent Licenses
Grantor
Description of
Patent License
Patent Number of
underlying Patent
Name of Licensor
(E)
Trademarks
Grantor
Jurisdiction
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
EXHIBIT A-5
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
EXHIBIT A-6
SUPPLEMENT TO SCHEDULE 5.4 TO
THIRD LIEN PLEDGE AND SECURITY AGREEMENT
Financing Statements:
Grantor
Filing Jurisdiction(s)
EXHIBIT A-7
SUPPLEMENT TO SCHEDULE 5.6 TO
THIRD LIEN PLEDGE AND SECURITY AGREEMENT
EXHIBIT A-8
EXHIBIT B
TO THIRD LIEN PLEDGE AND SECURITY AGREEMENT
UNCERTIFICATED SECURITIES CONTROL AGREEMENT
This Uncertificated Securities Control Agreement (this "Agreement") dated as of
[
], 20[
] among [
] (the
"Pledgor"), Wilmington Trust, National Association, as collateral agent for the
Secured Parties, (together with its successors and assigns in such capacity, the
"Collateral Agent") and [
], a [
]
[corporation] (the "Issuer").
Capitalized terms used but not defined herein
shall have the meaning assigned in the Third
Lien Pledge and Security Agreement
dated [as of the date hereof], among the Pledgor, the other Grantors party
thereto and the Collateral Agent (the "Security Agreement").
All references
herein to the "UCC" shall mean the Uniform Commercial Code as in effect in the
State of New York.
Section 1.
Registered Ownership of Shares.
The Issuer hereby confirms and
agrees that as of the date hereof the Pledgor is the registered owner of
[
] shares of the Issuer's [common] stock