Ucc1ad Financing Statement Addendum - Amazon Web Services Page 3
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1
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3ADDENDUM
UCC FINANCING STATEMENT
FOLLOW INSTRUCTIONS
9. NAME OF FIRST DEBTOR: Same as item 1a or 1b on Financing Statement; If line
1b was left blank because individual Debtor name did not fi t, check here
9a. ORGANIZATION’S NAME
OR
9b. INDIVIDUAL’S SURNAME
FIRST PERSONAL NAME
ADDITIONAL NAME(S) INITIAL(S)
SUFFIX
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
10
. DEBTOR’S NAME: Provide (10a or 10b) only one additional Debtor name or Debtor name that did not fi t in line 1b or 2b of the Financing Statement (Form UCC1) (use
exact full name; do not omit, modify, or abbreviate any part of the Debtor’s name) and enter the mailing address in line 10c
10a. ORGANIZATION’S NAME
OR
10b. INDIVIDUAL’S SURNAME
INDIVIDUAL’S FIRST PERSONAL NAME
INDIVIDUAL’S ADDITIONAL NAME(S) INITIAL(S)
SUFFIX
10c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
11.
ADDITIONAL SECURED PARTY’S NAME or
ASSIGNOR SECURED PARTY’S NAME: Provide only one name (11a or 11b)
11a. ORGANIZATION’S NAME
OR
11b. INDIVIDUAL’S SURNAME
FIRST PERSONAL NAME
ADDITIONAL NAME(S) INITIAL(S)
SUFFIX
11c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
12. ADDITIONAL SPACE FOR ITEM 4 (COLLATERAL):
13.
This FINANCING STATEMENT is to be fi led (for record)
14. This FINANCING STATEMENT:
(or recorded) in the REAL ESTATE RECORDS (If applicable)
covers timber to be cut
covers as-extracted collateral
is fi led as a fi xture fi ling
15. Name and address of a RECORD OWNER of real estate described in
16. Description of real estate:
Item 16 (if Debtor does not have a record interest):
17. MISCELLANEOUS:
Note: All information on this form is public record.
UCC FINANCING STATEMENT ADDENDUM (TN FORM UCC1Ad) (REV. 12/1/2016)
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