Ucc Financing Statement Additional Party
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2UCC FINANCING STATEMENT ADDITIONAL PARTY
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
19. NAME OF FIRST
(1a or 1b) ON RELATED FINANCING STATEMENT
19a. ORGANIZATION'S NAME
OR
19b. INDIVIDUAL'S LAST NAME
FIRST NAME
MIDDLE NAME,SUFFIX
20. MISCELLANEOUS:
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THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
21. ADDITIONAL
EXACT FULL LEGAL NAME
- insert only one name (21a or 21b) - do not abbreviate or combine names
21a. ORGANIZATION'S NAME
OR
21b. INDIVIDUAL'S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
21c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
21d. SEE INSTRUCTIONS
ADD'L INFO RE
21e. TYPE OF ORGANIZATION
21f. JURISDICTION OF ORGANIZATION
21g. ORGANIZATIONAL ID #, if any
ORGANIZATION
DEBTOR
NONE
22. ADDITIONAL
EXACT FULL LEGAL NAME
- insert only one name (22a or 22b) - do not abbreviate or combine names
22a. ORGANIZATION'S NAME
OR
22b. INDIVIDUAL'S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
22c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
22d. SEE INSTRUCTIONS
ADD'L INFO RE
22e. TYPE OF ORGANIZATION
22f. JURISDICTION OF ORGANIZATION
22g. ORGANIZATIONAL ID #, if any
ORGANIZATION
DEBTOR
NONE
23. ADDITIONAL
EXACT FULL LEGAL NAME
- insert only one name (23a or 23b) - do not abbreviate or combine names
23a. ORGANIZATION'S NAME
OR
23b. INDIVIDUAL'S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
23c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
23d. SEE INSTRUCTIONS
ADD'L INFO RE
23e. TYPE OF ORGANIZATION
23f. JURISDICTION OF ORGANIZATION
23g. ORGANIZATIONAL ID #, if any
ORGANIZATION
DEBTOR
NONE
24. ADDITIONAL
NAME
(or Name of TOTAL ASSIGNEE) - insert only one name (24a or 24b)
24a. ORGANIZATION'S NAME
OR
24b. INDIVIDUAL'S LAST NAME
MIDDLE NAME
FIRST NAME
SUFFIX
24c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
25. ADDITIONAL
NAME
(or Name of TOTAL ASSIGNEE) - insert only one name (25a or 25b)
25a. ORGANIZATION'S NAME
OR
25b. INDIVIDUAL'S LAST NAME
MIDDLE NAME
FIRST NAME
SUFFIX
25c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
FILING OFFICE COPY —
UCC FINANCING STATEMENT ADDITIONAL PARTY (FORM UCC1AP) (REV. 05/22/02)
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