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Fill and Sign the A Debtor May File a Correction Statement to Notify the Public that the Form

Fill and Sign the A Debtor May File a Correction Statement to Notify the Public that the Form

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CORRECTION STATEMENT FOLLOW INSTRUCTIONS (front and back) CAREFULLY B. SEND ACKNOWLEDGMENT TO: (Name and Address) THE AB OVE SPACE IS FOR FILIN G OFFICE USE ONLY 1.Identification of the RECORD to which this CORRECTION STATEMENT relates 1a. TYPE OF RECORD 2a. Provide the basis for the belief of the person identified in item 4 that the RECORD identified in item 1 is inaccurate and indicate the manner in which the person believes the RECORD should be amended to cure the inaccuracy. 2b. RECORD was wrongfully filed. 3. If this CORRECTION STATEMENT relates to a RECORD filed ( or recorded) in a filing offices described in Section 9-501(a)(1) and this CORRECTION STATEMENT is filed in such a filing office provide the date [and time] on which the INITIAL FINANCING STATEMENT identified in item 1b above was filed [or recorded] 4. NAME OF PERSON AUTHORIZING THE FILING OF THIS CORRECTION STATEMENT -- The RECORD identified in item 1 must be indexed under this name OR MIDDLE NAME SUFFIX A. NAME & PHONE OF CONTACT AT FILER [optional] 3a. DATE 3b. TIME 1a. ORGANIZATION'S NAME Provide the basis for the belief of the person identified in item 4 that the RECORD identified in item 1 was wrongfully filed. 1b. FILE # OF INITIAL FINANCING STATEMENT RECORD is inaccurate. A debtor may file a Correction Statement to notify the public that th e debtor believes the information on record is inaccurate or that the record was wrongfully filed. The filing of a Correction Statement does not affect the status of any UCC filing, nor does the filing officer effect changes on the record as a result of a Correction Statement. A secured party may file an Amendment (Form UCC 3) if the secured party wants to change or correct an existing filing. FILING OFFICE COPY -- NATIONAL CORRECTION STATEMENT (FORM UCC5) (REV. 05/22/02) 1b. INDIVIDUAL'S LAST NAME FIRST NAME 205-CORR Rev 05/22/02 Please type or laser-print this form. Be sure it is completely legible. Read all instructions, especially Instructions 1a and 1b; correct identification of the initialRecord to which this Correction Statement relates is crucial. Follow Instructions completely. Fill this form in very carefully. If you have any questions, consult your attorney. Filing office cannot give legal advice. Do not insert anything in the open space in the upper portion of this form; It is reserved for filing office use. When properly completed, send Filing Office Copy to filing office. If you want an acknowledgement, complete item B and, if filing in a filing office that returns an acknowledgement copy furnished by filer, you may also send Acknowledgment Copy; otherwise detach. Always detach Debtor and Secured Party Copies. A. To assist filing offices that might wish to communicate with filer, filer may provide information in item A. This item is optional B. Complete item B if you want an acknowledgment sent to you. If filing in a filing office that returns an acknowledgment copy furnished by filer, present simultaneously with this form General -- You must always complete items 1 and 4 and either 2a or 2b. You 3. If this Correction Statement relates to a Record filed [or recorded] in a may also be required to complete item 3. filing office described in Section 9-501(a)(1) and this Correction Statement is filed in such a filing office, provide the date [and time] on which the Initial 1a. Indicate type of Record to which this Correction Statement relates (eg., Financing Statement identified in item 1b above was filed [or recorded] Financing Statement or Amendment). You may also insert additional information that you believe will assist in identifying the Record (e.g., the 4. Always enter name of the person who authorized the filing of this filing date and/or record number of the Record). Correction Statement. This name must be the same as the name under which the Record is indexed. 1b. File number: Enter file number of initial financing statement to which the Record that is the object of this Correction Statement relates. Enter only one file number 2. If this Correction Statement is filed based on the filer's believes that the Record identified in item 1 is inaccurate, check box 2a, provide the basisfor that belief, and indicate the manner in which the Record should beamended to cure the inaccuracy. If this Correction Statement is filed based on the filer's belief that the Record identified in item 1 was wrongfully filed, check box 2b and providethe basis for that belief Instructions for National UCC Correction Statement (Form UCC5) 205-CORR Rev 05/22/02

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