Ucc Financing Statement Addendum
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1
2ADDENDUM
UCC FINANCING STATEMENT
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
DEBTOR
8. NAME OF FIRST
(1a or 1b) ON RELATED FINANCING STATEMENT
8a. ORGANIZATION'S NAME
OR
8b. INDIVIDUAL'S LAST NAME
FIRST NAME
MIDDLE NAME,SUFFIX
9. MISCELLANEOUS:
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
10. DEBTOR'S
EXACT FULL LEGAL NAME
- insert only one debtor name (10a or 10b) - do not abbreviate or combine names
10a. ORGANIZATION'S NAME
OR
10b. INDIVIDUAL'S LAST NAME (i.e. FAMILY NAME or SURNAME)
FIRST NAME
MIDDLE NAME
SUFFIX
10c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
10d. Check only if applicable and check only one box:
Debtor is a Trust
Debtor is a Trustee acting with respect to property held in trust
Debtor is a Decedent's Estate
SECURED PARTY'S
ASSIGNOR S/P'S
11.
ADDITIONAL
NAME
or
- insert only one name (11a or 11b)
11a. ORGANIZATION'S NAME
OR
MIDDLE NAME
11b. INDIVIDUAL'S LAST NAME (i.e. FAMILY NAME or SURNAME)
FIRST NAME
SUFFIX
CITY
STATE
POSTAL CODE
COUNTRY
11c. MAILING ADDRESS
12.
16.
This FINANCING STATEMENT is to be filed [for record] (or recorded) in the
Additional collateral description:
REAL ESTATE RECORDS. [if applicable]
13.
This FINANCING STATEMENT covers
timber to be cut or
as-extracted
collateral, or is filed as a
fixture filing.
14.
Description of real estate:
15.
Name and address of a RECORD OWNER of above-described real estate
(if Debtor does not have a record interest):
International Association of Commercial Administrators (IACA)
UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. DRAFT 04/15/09)
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