Form Ucc-3 - Financing Statement Amendment - 2009
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1
2STATE OF CONNECTICUT
UCC-3 FINANCING STATEMENT AMENDMENT
MAILING ADDRESS:
COURIER ADDRESS:
Commercial Recording Division
Commercial Recording Division
Connecticut Secretary of the State
Connecticut Secretary of the State
P.O. Box 150470
30 Trinity Street
Hartford, CT 06115-0470
Hartford, CT 06106
860-509-6002
860-509-6002
Follow Instructions Carefully
FEE: $50.00
Requesting Party
Cust ID ________________
(Space for filing office use only)
Name
Address
City
State
Zip
1.
INITIAL FINANCING STATEMENT FILE #
2.
TERMINATION
: Effectiveness of the Financing Statement identified above is terminated with respect to security interest(s) of the Secured Party authorizing this Termination Statement.
CONTINUATION:
3.
Effectiveness of the Financing Statement identified above with respect to security interest(s) of the Secured Party authorizing this Continuation Statement is continued for
the additional period provided by applicable law.
4.
ASSIGNMENT
(full or partial): Give name of assignee in item 7a or 7b and address of assignee in item 7c; and also give name of assignor in item 9.
.
5.
AMENDMENT (PARTY INFORMATION): This
Amendment affects
Debtor or
Secured Party of record
Check Only one of these two boxes.
Also check one of the following boxes and provide appropriate information in items 6 and/or 7.
CHANGE name and/or address: Give current record name in item 6a or 6b; also give new
DELETE name: Give record name
ADD name: Complete item 7a or 7b and also item
7c;
to be deleted in item 6a or 6b.
also complete items 7d-7g (if applicable).
name (if name change) in item 7a or 7b and/or new address (if address change) in item 7c
6.
CURRENT RECORD INFORMATION
6a. ORGANIZATION’S NAME
OR
6b. INDIVIDUAL’S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
7.
CHANGED (NEW) OR ADDED INFORMATION:
7a. ORGANIZATION’S NAME
OR
7b. INDIVIDUAL’S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
7c.
MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
7d.
TAX ID# EIN
ADD’L INFO RE
7e. TYPE OF ORGANIZATION
7f. JURISDICTION OF ORGANIZATION
7g. ORGANIZATIONAL ID #, OPTIONAL
ORGANIZATION
DEBTOR
8. AMENDMENT (COLLATERAL CHANGE): check only one box.
Describe collateral
deleted or
added, or give entire
restated collateral description, or describe collateral
assigned
9. NAME
PARTY
RECORD AUTHORIZING THIS AMENDMENT
OF
OF
(name of assignor, if this is an Assignment). If this is an Amendment authorized by a Debtor which
Amendment.
adds collateral or adds the authorizing Debtor, or if this is a Termination authorized by a Debtor, check here
and enter name of Debtor authorizing this
9a. ORGANIZATION’S NAME
OR
9b. INDIVIDUAL’S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
10.
OPTIONAL FILER REFERENCE DATA
FILING OFFICE COPY – CONNECTICUT UCC FINANCING STATEMENT AMENDMENT (Form UCC 3)
Revised 12/07/09
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