Ucc Financing Statement Addendum Form - State Of Connecticut
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1
2STATE OF CONNECTICUT
UCC FINANCING STATEMENT ADDENDUM
FOLLOW INSTRUCTIONS CAREFULLY
7.
NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT
7a. ORGANIZATION’S NAME
OR
7b. INDIVIDUAL’S LAST NAME
FIRST NAME
MIDDLE NAME, SUFFIX
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
8.
ADDITIONAL DEBTOR’S EXACT FULL LEGAL NAME – insert only one debtor name (8a or 8b) – do not abbreviate or combine names
8a. ORGANIZATION’S NAME
OR
8b. INDIVIDUAL’S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
8c
ADD’L INFO RE
8d. TYPE OF ORGANIZATION
8e. JURISDICTION OF ORGANIZATION
8f. ORGANIZATIONAL ID # (OPTIONAL)
ORGANIZATION
DEBTOR
9.
ADDITIONAL SECURED PARTY’S or
ASSIGNOR S/P’S NAME - insert only one name (9a or 9b)
9a. ORGANIZATION’S NAME
OR
9b. INDIVIDUAL’S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
9c
MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
10.
Additional collateral description:
11.
Check only if applicable. Check only one box.
Debtor is:
Trust
Trustee acting with respect to property held in trust
Decedent’s Estate
12.
Check only if applicable
Debtor is a TRANSMITTING UTILITY
Filed in connection with Public Finance Transaction
FILING OFFICE COPY – CONNECTICUT UCC FINANCING STATEMENT ADDENDUM (FORM UCC1 Ad) (REV. 07/14/2004)
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