UCC FINANCING STATEMENT AMENDMENT |
FOLLOW INSTRUCTIONS |
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A. | NAME & PHONE OF CONTACT AT FILER (optional) |
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B. | EMAIL CONTACT AT FILER (optional) |
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C. | SEND ACKNOWLEDGMENT TO: (Name and Address) |
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THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY |
1a. | INITIAL FINANCING STATEMENT FILE NUMBER | |
1b. | This FINANCING STATEMENT AMENDMENT is to be filed (for record) (or recorded) in the REAL ESTATE RECORDS. Filer: attach Amendment Addendum (Form UCC3 Ad) 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 Statement. |
3. | □ 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 8. |
4. | □ 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 law. |
5. | □ PARTY INFORMATION CHANGE: Check one of these two boxes: This Change affects □ Debtor or □ Secured Party of record |
| AND |
| Check 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 6b. |
6. | CURRENT RECORD INFORMATION: Complete for Party Information Change - provide only one name (6a or 6b) (use exact, full name; do not omit, modify, or abbreviate any word in the Debtor's name) |
| 6a. | ORGANIZATION'S NAME |
OR | |
| 6b. | 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 omit, modify, or abbreviate any word in the Debtor's name) |
| 7a. | ORGANIZATION'S NAME |
OR | |
| 7b. | INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME | ADDITIONAL NAME(S)/INITIAL(S) THAT ARE PART OF THE NAME OF THIS DEBTOR | SUFFIX |
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| 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 collateral |
| Indicate 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 Debtor |
| 9a. | ORGANIZATION'S NAME |
OR | |
| 9b. | INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME | ADDITIONAL NAME(S)/INITIAL(S) | SUFFIX |
10. | OPTIONAL FILER REFERENCE DATA |
[UCC FINANCING STATEMENT AMENDMENT (FORM UCC3)] (REV. 09/30/10) |
UCC FINANCING STATEMENT AMENDMENT ADDENDUM |
FOLLOW 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 |
OR | |
| 12b. | INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME | ADDITIONAL NAME(S)/INITIAL(S) | SUFFIX |
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY |
13. | 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 for item 13 - insert only one Debtor name (13a or 13b) (use exact, full name; do not omit, modify, or abbreviate any word in the Debtor's name) |
| 13a. | ORGANIZATION'S NAME |
OR | |
| 13b. | 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 filing |
16. | 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: |
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UCC FINANCING STATEMENT AMENDMENT ADDENDUM (FORM UCC1) (REV. 09/30/10) |