Form Ucc3 - Ucc Financing Statement Amendment
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1
2AMENDMENT
UCC FINANCING STATEMENT
FOLLOW INSTRUCTIONS (font and back) CAREFULLY
A. NAME & PHONE OF CONTACT AT FILER [optional]
B. SEND ACKNOWLEDGMENT TO: (Name and Address)
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
1a. INITIAL FINANCING STATEMENT FILE#
1b.
This FINANCING STATEMENT AMENDMENT is
to be filed [for record] (or recorded) in the
REAL ESTATE RECORDS.
2.
TERMINATION:
Effectiveness of the Financing Statement identified above is terminated with respect to security interest(s) of the Secured Party authorizing this Termination Statement.
3.
CONTINUATION:
Effectiveness of the Financing Statement identified above with respect to security interest(s) of the Secured Party authorizing this Continuation Statement is continued
for the additional period provided by applicable law.
4.
ASSIGNMENT
(full or partial): Give name of assignee in item 7a or 7b and address of assignee in item 7c; and also give name of assignor in item 9.
5. AMENDMENT (PARTY INFORMATION):
This Amendment effects
Debtor or
Secured Party of record. Check only one of these two boxes.
Also check one of the following three boxes and provide appropriate information in items 6 and/or 7.
CHANGE name and/or address: Please refer to the detailed instructions
DELETE name: Give record name
ADD name: Complete item 7a or 7b, and also
in regards to changing the name/address of a party.
to be deleted in item 6a or 6b.
item 7c; also complete items 7e-7g (if applicable)
CURRENT RECORD INFORMATION:
6.
6a. ORGANIZATION’S NAME
OR
6b. INDIVIDUAL’S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
7. CHANGED (NEW) or ADDED INFORMATION
7a. ORGANIZATION’S NAME
OR
7b. INDIVIDUAL’S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
7c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
ADD’L INFO RE
7d. SEE INSTRUCTIONS
7e. TYPE OF ORGANIZATION 7f. JURISDICTION OF ORGANIZATION
7g. ORGANIZATION ID#, if any
ORGANIZATION
NONE
DEBTOR
8. AMENDMENT (COLLAERAL CHANGE):
check only one box.
Describe collateral
deleted or
added, or give entire
restated collateral description, or describe collateral
assigned.
9. NAME
SECURED PARTY
RECORD AUTHORIZING THIS AMENDMENT
OF
OF
(name of assignor, if this is an Assignment). If this is an Amendment authorized by a Debtor
which adds collateral or adds the authorizing Debtor, or if this is a Termination authorized by a Debtor, check here
and enter name of DEBTOR authorizing this Amendment.
9a. ORGANIZATION’S NAME
OR
9b. INDIVIDUAL’S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
10. OPTIONAL FILER REFERENCE DATA
FILING OFFICE COPY – UCC FINANCING STATEMENT AMMENDMENT (FORM UCC3) (REV. 05/22/02)
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