Form Ucc-11 - Information Request
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1UCC-11
STATE OF SOUTH CAROLINA FILING FEES:
$ 5.00 - Each filing
$ 2.00 - Additional for additional Debtors (i.e., DBA)
$ 2.00 - Copies (First Page)
$ 2.00 - Certification (Per Copy)
$ 5.00 - Fax Fee: Incoming (Per Search)
INFORMATION REQUEST
$ 1.00 - Copies (Additional Page)
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
$10.00 - Fax Fee: Outgoing (Per Search)
A. NAME & PHONE OF CONTACT [optional]
FILING OFFICE ACCT #
B. RETURN TO: (Name and Address)
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
DEBTOR
1.
NAME to be searched -
insert only one debtor name (1a or 1b) - do not abbreviate or combine names
1a. ORGANIZATION'S NAME
OR
1b. INDIVIDUAL'S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
INFORMATION OPTIONS
2.
relating to UCC filings and other notices on file in the filing office that include as a Debtor name the name identified in item 1:
2a. SEARCH RESPONSE
CERTIFIED (Optional)
ALL
UNLAPSED
Select one of the following two options:
(Check this box to request a response that is complete, including filings that have lapsed.)
2b. COPY REQUEST
CERTIFIED (Optional)
ALL
UNLAPSED
Select one of the following two options:
2c. SPECIFIED COPIES ONLY
CERTIFIED (Optional)
Record Number
Date Record Filed
Type of Record and Additional Identifying Information
(if required)
( if required)
ADDITIONAL SERVICES:
3.
4. DELIVERY INSTRUCTIONS: (request will be completed and mailed to the address shown in item B unless otherwise instructed here);
4a. [ ] Pick Up
4b. [ ] Other ____________________________________________________________________________________________________________________
Specify desired method here (if available from this office); provide delivery information (e.g., delivery service's name, addressee's account # with delivery service, addressee's phone #, etc.)
The undersigned filing office hereby certifies that the above listing is a record of all presently effective financing statements and statements of assignment which name the above debtor,
Additional fee required $
Dated this
day of
A.D., 20
(Signature of Filing Officer)
FILING OFFICE COPY (1) —
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