Form Ucc-11 - Request For Information Or Copies printable pdf download

Uniform Commercial Code - REQUEST FOR INFORMATION OR COPIES - Form UCC-11

IMPORTANT - Read instructions before filling out form

____________________________________________________________________________________

1. Debtor (Last Name First) and Address:

Party requesting information or copies:

4. For Filing Officer Use:

(Name and Address)

___________________________________________________________________________________________________________________________________

” INFORMATION REQUEST (SEARCH):

” COPY REQUEST (COPIES):

Filing officer please furnish certificate showing whether there is on file as of _____________, 20 ____ at _____ __M., any

presently effective financing statement naming the above named debtor(s) and any statement of assignment thereof, and if there is,

giving the date of each such statement and the name(s) and address(es) of each securied party(ies) therein. The statutory fee is

enclosed.

Filing officer please furnish exact copies of each page of financing statements and statements of assignment listed below, which

are on file with your office. Enclosed is $ ____________ fee for copies requested. In case any of said statements contain

more than one page the undersigned agrees to pay the statutory fee for each additional page payable in advance.

DATE: _____________________

Signature of Requesting Party:

________________________________________________________________________________________

____________________________________________________________________________________________________

File Number

Date of Filing

Name(s) and Address(es) of Secured Party(ies) and Assignees, if any

____________________________________________________________________________________________________

CERTIFICATE: The undersigned filing officer hereby certifies that:

”

the above listing is a record of all presently effective financing statements and statements of assignment which name

the above debtor(s) and which are on file in my office as of __________________ , 20____ at __________ __M.

”

the attached _________ pages are true and exact copies of all available financing statements or statements of

assignment listed in above request.

______________________

________________________________________________

DATE

SIGNATURE OF FILING OFFICER

STANDARD FORM - FORM UCC-11 - Approved by Secretary of State of New York

6/1/2000

Form Ucc-11 - Request For Information Or Copies