Fillable Printable Standard UCC Financing Statement Addendum
Fillable Printable Standard UCC Financing Statement Addendum
Standard UCC Financing Statement Addendum
15.Name and address of a RECORD OWNER of above-described real estate
(if Debtor does not have a record interest):
17. Check only if applicable and check only one box.
Debtor is a
Trust orTrustee acting with respect to property held in trust or
Decedent's Estate
18. Check only if applicable and check only one box.
FILING OFFICE COPY UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 05/22/02)
Debtor is a TRANSMITTING UTILITY
Filed in connection with a Manufactured-Home Transaction effective 30 years
Filed in connection with a Public-Finance Transaction effective 30 years
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
FIRST NAME
CITY
STATE
11e. TYPE OF ORGANIZATION
COUNTRY
11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only one name (11a or 11b) - do not abbreviate or combine names
11c. MAILING ADDRESS
OR
11a. ORGANIZATION'S NAME
11b. INDIVIDUAL'S LAST NAME
11d. SEE INSTRUCTIONS
11f. JURISDICTION OF ORGANIZATION
MIDDLE NAME
POSTAL CODE
SUFFIX
ADD'L INFO RE
ORGANIZATION
DEBTOR
NONE
12. ADDITIONAL SECURED PARTY'Sor ASSIGNOR S/P'S NAME- insert only one name (12a or 12b)
OR
14.Description of real estate:
fixture filing.
12c. MAILING ADDRESSCITY
STATE
SUFFIX
MIDDLE NAMEFIRST NAME12b. INDIVIDUAL'S LAST NAME
12a. ORGANIZATION'S NAME
collateral, or is filed as a
13. This FINANCING STATEMENT covers
timber to be cut or
as-extracted16. Additional collateral description:
11g. ORGANIZATIONAL ID #, if any
POSTAL CODECOUNTRY
OR
UCC FINANCING STATEMENT ADDENDUM
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
9. NAME OF FIRST DEBTOR (1a or 1b) ONRELATED FINANCING STATEMENT
9a. ORGANIZATION'S NAME
9b. INDIVIDUAL'S LAST NAME
10. MISCELLANEOUS:
MIDDLE NAME,SUFFIX
FIRST NAME
Instructions for UCC Financing Statement Addendum (Form UCC1Ad)
9.Insert name of first Debtor shown on Financing Statement to which this Addendum relates, exactly as shown in item 1 of Financing Statement.
10.Miscellaneous: Under certain circumstances, additional information not provided on Financing Statement may be required. Also, some states have
non-uniform requirements. Use this space to provide such additional information or to comply with such requirements; otherwise, leave blank.
11.If this Addendum adds an additional Debtor, complete item 11 in accordance with Instruction 1 of Financing Statement. To include further additional
Debtors, attach either an additional Addendum (Form UCC1Ad) or Additional Party (Form UCC1AP) and follow Instruction 1 of Financing Statement
for determining and formatting additional names.
12.If this Addendum adds an additional Secured Party, complete item 12 in accordance with Instruction 3 of Financing Statement.To include further
additional Secured Parties, attach either an additional Addendum (Form UCC1Ad) or Additional Party (Form UCC1AP) and follow Instruction 1
of Financing Statement for determining and formatting additional names. In the case of a total assignment of the Secured Partys interest before
the filing of this Financing Statement, if filer has given the name and address of the Total Assignee in item 3 of Financing Statement, filer may
give the Assignor S/Ps name and address in item 12.
13-15.Ifcollateral is timber to be cut or as-extracted collateral, or if this Financing Statement is filed as a fixture filing, check appropriate box in item 13; provide
description of real estate in item 14; and, if Debtor is not a record owner of the described real estate, also provide, in item15, the name and address
of a record owner. Also provide collateral description in item 4 of Financing Statement. Also check box 6 on Financing Statement. Description of real
estate must be sufficient under the applicable law of the jurisdiction where the real estate is located.
16.Use this space to provide continued description of collateral, if you cannot complete description in item 4 of Financing Statement.
17.If Debtor is a trust or a trustee acting with respect to property held in trust or is a decedents estate, check the appropriate box.
18.If Debtor is a transmitting utility or if the Financing Statement relates to a Manufactured-Home Transaction or a Public-Finance Transaction as defined
in the applicable Commercial Code, check the appropriate box.
