South Dakota Financing Statement - Ucc 3 Approved Standard Form
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SOUTH DAKOTA FINANCING STATEMENT – UCC 3
APPROVED STANDARD FORM
Fee $ __________________
Secretary of State
HELP
500 E. Capitol Pierre, SD 57501-5070 605-773-4422
Account #_______________
PLEASE TYPE THE INFORMATION ON THIS FORM ACCORDING TO ALL INSTRUCTIONS PRINTED ON THE BACK OF THE UCC 3 FORM
NOTE: Type smaller than 8 point is not acceptable. This is an example of 8 point type.
1. SECURED PARTY NAME AND ADDRESS insert only one secured party name (1a or 1b)
1a. ORGANIZATION’S NAME
or
1b. INDIVIDUAL’S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
1c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
2. ASSIGNEE OF SECURED PARTY NAME AND ADDRESS insert only one assignee name (2a or 2b)
2a. ORGANIZATION’S NAME
or
2b. INDIVIDUAL’S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
2c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
3. DEBTOR’S EXACT FULL LEGAL NAME – insert only one debtor (3a or 3b) – do not abbreviate or combine names.
3a. ORGANIZATION’S NAME
or
3b. INDIVIDUAL’S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
3c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
3d.
ADD’S INFO RE
3e. TYPE OF ORGANIZATION
3f. JURISDICTION OF ORGANIZATION
3G. ORGANIZATIONAL ID#, if any
TAX ID # SSN OR EIN
ORGANIZATION
NONE
DEBTOR
4. ADDITIONAL DEBTOR’S EXACT FULL LEGAL NAME – insert only one debtor name (4a or 4b) – do not abbreviate or combine names.
4a. ORGANIZATION’S NAME
or
4b. INDIVIDUAL’S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
4c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
4f. JURISDICTION OF ORGANIZATION
4d.
ADD’S INFO RE
4e. TYPE OF ORGANIZATION
4G. ORGANIZATIONAL ID#, if any
TAX ID # SSN OR EIN
ORGANIZATION
NONE
DEBTOR
THIS STATEMENT REFERS TO ORIGINAL FINANCING STATEMENT NO. ___________________________________________________________ (limited to one transaction per UCC 3)
DATE _________________________________________________ FILED WITH ________________________________________________________________________________
CONTINUATION
TERMINATION
ASSIGNMENT
AMENDMENT
The financing statement bearing the above file number is
The secured party no longer claims a security interest under
The secured party’s rights to the property described below
The financing statement bearing the above file number is
still effective. Cannot be filed more than six months prior to
the financing statement bearing the above file number.
under the statement bearing the above file number have
amended as set forth below. Must be signed by both
the expiration date. Must be signed by secured party for
Must be signed by secured party for effective financing
been assigned to the assignee whose name and address
debtor and secured party for Effective Financing Statement.
effective financing statements.
statements.
are listed above. Must be signed by secured party and
debtor for Effective Financing Statement.
Fee: $25 and $3 for each additional debtor name
Fee: $25 and $3 for each additional debtor name
Fee: None
Fee: $25 and $3 for each additional debtor name
This area is for the description of collateral, release, collateral if assigned, or description of real estate, if necessary:
Check (X) if covered:
PROCEEDS of collateral are also covered.
PRODUCTS of collateral are also covered.
Use the following spaces only for Farm Products requiring EFFECTIVE FINANCING STATEMENT (EFS)
LOCATION IN COUNTY OR
FARM PRODUCT
YEAR
QUANTITY
COUNTY CODE
FURTHER DESCRIPTION
Pay proceeds to Debtor and Secured Party unless otherwise checked:
Secured Party only
Debtor only
Filed with the Secretary of State as
UCC
EFS
BOTH
Number of Additional Sheets, if any _____________________
Signature(s) of Debtor(s)
Signature of Secured Party
UCC 3 FORM Revised 07/01/2009
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