Fill and Sign the Amendment for an Effective Financing Statement Wyoming Form

State of Wyoming Effective Financing Statement (EFS) Debtor Name Social Security# or Employer ID# Secured Party and Address 1. ________________________ _____ _____ _____ 2. ________________________ _____ _____ _____ 3. ________________________ _____ _____ _____ Mailing Address Assignee of Secured Party and Address CHECK (X) IF ALSO COVERED PROCEEDS OF COLLATERAL PRODUCTS OF COLLATERAL Pay proceeds to debtor and secured party unless otherwise checked Secured Party Only Debtor Only ATT ACHMENTS Use the following for Farm Products requiring EFFECTIVE FINANCING STATEMENT (EFS) filing in accordance with the Food Security Act of 1985. FARM PRODUCT CODE YEAR QUANTITY COUNTY LOCATION IN COUNTY OR CODE FURTHER DESCRIPTION ________________________________________________ ______________________________________________ MUST BE ORIGINALLY SIGNED Signature of Secured Party _____________________________________________________ _____________________________________________________ MUST BE ORIGINALLY SIGNED Signature of Debtor(s) FOR TERMINATION ONLY: To use Acknowledgment as a Termination Statement, Secured Party must date and sign below: Termination Statement dated: _________________________ Signed: ____________________________ Signature of Secured Party State of Wyoming Effective Financing Statement Secretary of State, The Capitol, Cheyenne, WY 82002 (307) 777-5372 Filing fee: $20.00 (Includes fee for termination statement) efs form.p65 $35.00 if more than two pages Revised 6/02