Information Request Form Maine
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2INFORMATION REQUEST (MAINE)
FOLLOW THE INSTRUCTIONS (front and back) CAREFULLY
A. NAME & PHONE OF REQUESTER (Optional)
B. EMAIL ADDRESS OF REQUESTER (Optional)
C. RETURN TO: (Name and Mailing Address)
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
1. DEBTOR NAME to be searched – One debtor name (1a or 1b) is required for all search requests – do not abbreviate or combine names.
1a. ORGANIZATION’S NAME
OR
1b. INDIVIDUAL’S SURNAME
FIRST PERSONAL NAME
ADDITIONAL NAME(S)/INITIALS
SUFFIX
2. INFORMATION OPTIONS relating to UCC filings and other notices on file in the filing office that include the Debtor name provided in item 1. A search response will be
generated based on the following search options you select:
2a. FILING STATUS:
ALL – Response includes all filings, including those that have lapsed.
UNLAPSED FILINGS
2b. SEARCH REPORT:
YES
NO
2c. CERTIFIED (Optional):
YES
(An additional $5 fee will be charged.)
2d. COPIES (SELECT ONLY ONE FORMAT):
ALL – All copies of the associated financing statements will be provided.
NO COPIES – Only a search report will be provided regardless of what is selected in 2b.
SPECIFIED COPIES - Select the options below to receive only specified copies of filings that include the Debtor name provided
in Item 1. This search will furnish exact copies of all financing statements, related records and other notices that include the Debtor
name provided in item 1.
Please note that by selecting any of the following options, you will limit the results of your search, which may not find all (or
any) of the financing statements that include the Debtor name provided in Item 1.
SPECIFIED TIME PERIOD: Records filed from ______________________ and to ______________________
MM/DD/YYYY
MM/DD/YYYY
SPECIFIED DEBTOR ADDRESS ONLY: Name of Town or City: ____________________________________
BY FILE NUMBER(S):
Check here if you would like all associated filings and notices with the File
Number(s) listed below on file in the Filing Office.
Enter only ONE File Number per line:
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
3. EXPEDITED SERVICE (Optional):
24 Hour ($10)
OR
Immediate ($25)
4. DELIVERY INSTRUCTIONS (Request will be completed and mailed to the address shown in item C above unless otherwise instructed here):
4a.
Pick up. Contact Name and Telephone Number: ________________________________________________________________________________
4b.
Email. (If the search results file is too large to email, it will be mailed.)
Email Address: _________________________________________________
4c.
Fed Ex. Please provide a completed airbill with return delivery instructions. Your completed airbill must contain your Fed Ex account number.
FILING OFFICE COPY – MAINE UCC INFORMATION REQUEST (FORM UCC11-ME) (REV. 07/01/2013) For Use in the State of Maine ONLY.
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