Fillable Ucc Form 11-A - Information Request printable pdf download

Ucc Form 11-A - Information Request

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SPACE BELOW IS FOR FILING OFFICE USE ONLY

New Hampshire UCC Form 11-A

Rec'd.

For Use in the State of New Hampshire

Search Fee

A. Name and Phone of contact at requestor (optional)

# Copies

Fee

B. Return to: (Name and address):

Total Due

Amt. Of Check

Check #

Cash Slip #

1. DEBTOR NAME - Insert only one debtor name in 1a. or 1b.

Picked Up

1a. Organization's name

1 b. Individual's Last Name

First Name

Middle Name

Suffix

2. INFORMATION OPTIONS

RELATING TO UCC FILINGS AND OTHER NOTICES FILED IN YOUR OFFICE THAT INCLUDE AS A DEBTOR

THE DEBTOR NAME INDICATED IN ITEM 1.

2a.

SEARCH CERTIFICATE

- Please furnish a certificate/report listing ALL (regardless of Debtor's address) presently effective financing

of each page of ALL financing statements, related subsequent filings including statements of assignment, and other notices, showing the date and time of filing.

SEARCH CERTIFICATE AND ALL COPIES

2 b.

- Please furnish search certificate/report

(as described in 2a above) and exact copies

of each page of ALL financing statements, related subsequent filings including statements of assignment, and other notices, including ALL attachment pages.

2c.

SEARCH COPIES ONLY

- Please furnish exact copies of each page of the financing statements, related subsequent filings including

statements of assignment, or other notices (including attachments) that are identified below by document locator number.

Document Locator #

Date Document Filed

2 d.

SEARCH CERTIFICATE and PARTIAL COPIES (ALL FILINGS - FIRST PAGES ONLY) -

Please furnish search

certificate/report (as described in 2a above) and exact copies of the FIRST PAGE ONLY of ALL financing statements, related filings including statements of

assignment, and other notices.

3. THIS FILING OFFICE OFFERS THE FOLLOWING ADDITIONAL SERVICES:

3a.

COPIES FOR SPECIFIED TIME PERIOD ONLY

- Please furnish exact copies of ALL financing statements, related subsequent

filings, including statements of assignment, and other notices, including ALL attachment pages, that include the Debtor name indicated in item 1 filed after

and prior to

4. SELECT ONE OF THE FOLLOWING:

4a. Search service:

(applicable only to the State UCC Office)

24-HOUR EXPEDITED

SAME-DAY EXPEDITED

ROUTINE

4b. Please do not make more copies than will be purchased by the following copy fee:

$100

No limit

$25

$50