Identification
Number of each Grantor:
Full Legal Name
Type of
Organization
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
SCHEDULE 5.1-1
SCHEDULE 5.2
TO 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
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
Pledged Debt:
Grantor
Issuer
Original
Principal
Amount
Outstanding
Principal
Balance
Issue Date
Maturity Date
SCHEDULE 5.2-1
Securities Account:
Grantor
Share of Securities
Intermediary
Account Number
Account Name
Deposit Accounts:
Grantor
Name of Depositary Bank
Account Number
Account Name
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
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
SCHEDULE 5.2-2
(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
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
SCHEDULE 5.2-3
SCHEDULE 5.4 TO
SECURITY AGREEMENT
FINANCING STATEMENTS:
Grantor
Filing Jurisdiction(s)
SCHEDULE 5.4-1
EXHIBIT A
TO SECURITY AGREEMENT
SECURITY AGREEMENT SUPPLEMENT
This SECURITY AGREEMENT SUPPLEMENT, dated as of [
], 20[
]
(this "Supplement"), is delivered by [NAME OF ADDITIONAL GRANTOR], a
[JURISDICTION AND ENTITY TYPE OF ADDITIONAL GRANTOR] ("Additional Grantor"),
pursuant to the Security Agreement, dated as of September 29, 2014 (as it may be
amended, restated,