Form Uo-1-1.0 - Ucc-1 Financing Statement - Connecticut Secretary Of State - 2010
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4SECRETARY OF THE STATE OF CONNECTICUT
MAILING ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, P.O. BOX 150470, HARTFORD, CT 06115-0470
DELIVERY ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, 30 TRINITY STREET, HARTFORD, CT 06106
860-509-6002
PHONE:
WEBSITE:
STATE OF CONNECTICUT
UCC-1 FINANCING STATEMENT
USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 81/2 X 11 SHEETS IF NECESSARY.
FILING FEE: $50
FILING PARTY
:
(CONFIRMATION WILL BE SENT TO THIS ADDRESS)
MAKE CHECKS PAYABLE TO "SECRETARY
CUSTOMER ID:
OF THE STATE"
NAME:
ADDRESS:
CITY:
STATE:
ZIP:
1. DEBTOR'S EXACT FULL LEGAL NAME -
INSERT ONLY ONE DEBTOR NAME (1A OR 1B) - DO NOT ABBREVIATE OR
COMBINE NAMES
1A. ORGANIZATION’S NAME
OR
1B. INDIVIDUAL’S
LAST NAME
FIRST NAME
MIDDLE
SUFFIX
1C. MAILING ADDRESS:
ADDRESS:
CITY:
STATE:
ZIP:
COUNTRY:
ADD'L INFO RE ORGANIZATION DEBTOR
1D. TYPE OF ORGANIZATION
1E. JURISDICTION OF ORGANIZATION
1F. ORGANIZATIONAL ID # OPTIONAL
2. ADDITIONAL DEBTORS EXACT FULL LEGAL NAME -
INSERT ONLY ONE DEBTOR NAME (2A OR 2B) - DO NOT
ABBREVIATE OR COMBINE NAMES
2A. ORGANIZATION’S NAME
OR
2B. INDIVIDUAL’S
LAST NAME
FIRST NAME
MIDDLE
SUFFIX
2C. MAILING ADDRESS:
ADDRESS:
CITY:
STATE:
ZIP:
COUNTRY:
FORM UO-1-1.0
PAGE 1 OF 2
Rev. 7/2010
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