Form Ucc-3 - Statement Of Change - 2000 printable pdf download

State of Florida

UNIFORM COMMERCIAL CODE

STATEMENT OF CHANGE

FORM UCC-3 (REV.2000)

This Statement of Change is presented to a filing officer pursuant to the Uniform Commercial Code:

1. Debtor (Last Name First if an individual)

1a. Date of Birth or FEI#

1b. Mailing Address

1c. City, State

1d. Zip Code

2. Additional Debtor or Trade Name (Last Name First if an individual)

2a. Date of Birth or FEI#

2b. Mailing Address

2c. City, State

2d. Zip Code

3. Secured Party (Last Name First if an individual)

3a. Mailing Address

3b. City, State

3c. Zip Code

4. Additional Secured Party (Last Name First if an individual)

4a. Mailing Address

4b. City, State

4c. Zip Code

5. This Statement refers to original Financing Statement bearing file number:

filed on

6. A.

Continuation -

The original Financing Statement between the Debtor and Secured Party bearing the file number shown above is continued.

Release -

The Secured Party releases the collateral described in Block 7 below from the Financing Statement bearing the file number shown

above. RELEASE DOES NOT TERMINATE LIEN AGAINST A DEBTOR.

Full Assignment -

All of the Secured Party’s rights under the Financing Statement have been assigned to the assignee whose name and address is shown

in Block 7 below.

Partial Assignment -

Some of Secured Party’s rights under the Financing Statement have been assigned to the assignee whose name and address in shown

in Block 7. A description of the collateral subject to the assignment is also shown in Block 7.

Amendment -

The Financing Statement bearing the file number shown above is amended as set forth in Block 7. (See instructions for signature

requirements)

Termination -

The Secured Party no longer claims an interest under the Financing Statement bearing the file number shown above.

Other -

7. Description of collateral released or assigned, Assignee name and address, or amendment. Use additional sheet(s) if necessary.

This space for use of Filing Officer

8. Signature(s) of Debtor(s): (only if amendment - see instructions)

9. Signature(s) of Secured party (ies):

10. Number of Additional Sheets Presented

11. Return Copy to:

Name

Address

City, State, Zip

STANDARD FORM - FORM UCC-3

Approved by Secretary of State, State of Florida

Form Ucc-3 - Statement Of Change - 2000

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