Instructions For Completing The Ucc-1 Financing Statement Page 2

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7. Collateral Description
Describe the collateral covered by this financing statement.
Supplemental sheets may be used to provide additional
information when there is a lack of space provided in box 7.
Additional sheets should be 8-1/2 x 11 inches. Staple or paper
clip additional sheets to the filing form.
Acknowledgment copies are normally returned to the
8. Acknowledgment Copies
secured party of record shown in box 3, or to the assignee
shown in box 4. Complete the Return Acknowledgment box
when you would like the acknowledgment copy mailed to a
party not shown in boxes 3 or 4.
Mail filing forms to:
9. Address
Uniform Commercial Code
Department of Licensing
PO Box 9660
Olympia WA 98507-9660
Make checks payable to the Department of Licensing.
Private carrier address:
405 Black Lake Boulevard
First Floor
Olympia WA 98502
10. Office Use Only
DO NOT WRITE IN THIS BOX.
11. Omission of Debtor's Signature
When box 11 is completed the secured party must sign in
box 13.
Complete the information in Numbers 1 - 3 when additional
information is requested by instructions in boxes a through d.
12. Debtor Signature
Print or type above the signature line the debtor name as it
appears in box 1. The personal debtor's signature should
appear the same as the personal name that is listed in box 1.
13. Secured Party Signature
Secured party(s) must sign the form when box 11 has been
completed. Print or type above the signature line the
secured party name(s) as it appears in box 3 or 4.
The Department of Licensing has a policy of providing equal access to its services. If
you need special accommodation, please call (360)664-1530 or TTY (360)664-8885.
UCC-740-001 UCC-1 Form (R/2/00) M/W Page 2 of 3

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