Fill and Sign the Fillable Online Tn Tn Form Ucc11 0713 Tn Fax Email Print

TN FORM UCC11 (07/13) Business Services Division Tre Hargett, Secretary of State State of Tennessee INSTRUCTIONS UCC Information Request ( TN Form UCC11) Filing Fee – Search Report Only $15.00 Search Report and Copies $15.00 + $1 .00 per page A UCC 11 information request may be filed using one of the following methods: • E-file: Go to http://tnbear.tn.gov/UCC . Use the online tool to complete the filing and pay the filing fee by credit card, debit card or ACH . When paying by credit card, debit card or ACH, there is a convenience fee that covers the credit card fees and transaction costs incurred by the Business Services Division when accepting online payments. Filers who do not wish to pay the convenience fee to file online may choose the “ Print and Mail” option at no additional cost. • Print and Mail: Go to http://tnbear.tn.gov/UCC . Use the online tool to complete the filing. Print and mail the application along with the required filing fee to the Secretary of State’s office at ATTN: UCC, 312 ROSA L PARKS AVE #6, NASHVILLE TN 37243 -1102 . • Paper submission: A blank form may be obtained by going to http://www.tn.gov/sos/forms/uc c1.pdf , by emailing the Secretary of State at Business.Services@tn.gov , or by calling (615) 741 -3276 . The application is hand printed in black ink or computer generated and mailed along with the required filing fee to the Secretary of State’s office at ATTN: UCC, 312 ROSA L PARKS AVE #6, NASHVILLE TN 37243 -1102 . Please note that since the fee is calculated based on the number of copies returned, it will be necessary to call the filing office at (615) 741 -3276 to obtain a calculation of the fee prior to submittal. Paper submissions sent in without exact payment of the fee will be rejected. • Walk -in: A blank UCC1 1 form may be obtained in person at the Secretary of State Business Services Division located on the 6th F loor of the Snodgrass Tower at 312 Rosa L. Parks AVE, Nashville, TN 37243. Please type or laser -print this form. Be sure it is completely legible. Read all instructions, especially instruction 1; correct Debtor name is crucial. Follow instructions completely and fill in form very carefull y. This form can also be filed online at: http://tnbear.tn.gov/UCC . Do not insert anything in the open space in the upper portion or the right hand vertical margin of this form; it is reserved for filing office use . Send with the required fee to the filing office when properly completed. The fee includes a cost per page for copies. If you are requesting copies (2d, 2e, or 2f) , it is best to use our web based request form which will calculate the copies fee for you. If you do not have internet access, please complete this form and call our office to get he lp with the fee calculation. To assist filing offices that might wish to communicate with filer, filer may provi de information in items A and B. Enter the name and address where the information request results should be mailed in item C . 1. DEBTOR’S NAME - Enter only one Debtor name in item 1 : either an organization's name (1a) or an individual’s name (1b). A last name is required if 1b is completed. If a first name is entered (example “Robert ”); the search results will return all Debtors with the last name specified and a first name of “R” or “Robert”. A Debtor with the designated last name and the first name of ‘Bob’ or “Rob” will not be returned. 1c. Enter a city in 1c to limit the search results to a specific city. If you spell t he city name incorrectly, you are not likely to get any results. 1d . Enter a State (2 letter abbreviation preferred) in 1d t o limit the search results to a specific State. 1e. Check the box in 1e to conduct a secured party search (instead of a debtor search). Enter the secured part y information in 1a – 1d. 2. INFORMATION OPTIONS All search results and copies are Certified. There is not a separate option to select Certi fied Copies. 2a . Select one of the two checkboxes. You may only search records that are Active (i.e. unlapsed) or all records on file (lapsed and unlapsed). 2b . Select one of the two checkboxes. You can search all dates or a specified date range. 2c . Select ONE of th ese 3 boxes , or box 2d . • search response list only (UCC Lien Certified Search Report with UCC Listing) . • search response list and all copies (including attachment pages). • search response list and partial copies. Partial copies are the filing documents without attachments ( e.g. exhibits, tax receipts); sometimes referred to as “face pages ”. Filings processed in our office prior to July 1, 2013 will usually return all copies even if partial copies are selected. If the filer filed collateral description on exhibits/attachments, you must select all copies to obtain all col lateral information. 2d. Select box 2d to receive only specified copies. List the Document Locator Number of each copy requested in the boxes under 2 d. The specified copies must include the debtor name specified. 3. DELIVERY INSTRUCTIONS - Designate how you want the search results delivered. The results can be mailed t o the address designated in box C or picked up at our office. If your request is entered and paid online, the results will be delivered to you online at the end of the payment process in a zipped file of .pdf images. Filing Fee • The filing fee for a Search Report only is $15. 00. The filing fee for a Search Report with copies is $15 .00 plus $1 .00 per page. • Make check, cashier’s check or money order payable to the Tennessee Secretary of State. Cash i s only accepted for walk -in filings . Checks, cashier’s checks or money orders made out to any payee other than the Tennessee Secretary of State will not be accepted and will result in the rejection of document. INFORMATION REQUEST FOLLOW INSTURCTIONS CAREFULLY A. NAME & PHONE OF CONTACT AT REQUESTOR (Optional) B. EMAIL CONTACT AT REQUESTOR (Optional) C. RETURN TO: (Name & Address) 1. DEBTOR NAME to be searched - insert only ONE debtor name (1a or 1b) - do not abbreviate or combine names. OR 2a. SEARCH (select one checkbox) Active, unlapsed records only (default) All records on �le, lapsed and unlapsed 2b. SEARCH (select one checkbox) All dates (default) Filed on/after and through 2c. LIST ONLY LIST and ALL COPIES (including attachment pages) LIST and partial copies 2d. SPECIFIED COPIES ONLY UCC Doc. # UCC Doc. # UCC Doc. # UCC Doc. # UCC Doc. # / / Month Day Year / / Month Day Year 3. DELIVERY INSTRUCTIONS INFORMATION REQUEST (TN FORM UCC11) MODIFIED (REV. 07/01/2013) THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 2. INFORMATION OPTIONS relating to UCC �lings on �le in the �ling of�ce that include the name identi�ed in item 1: NOTE: All search results and copies are CERTIFIED. 1a. ORGANIZATION’S NAME 1b. INDIVIDUAL’S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S) INITIAL(S) SUFFIX 1c. LIMIT THE SEARCH TO THIS ONE CITY: 1d. LIMIT THE SEARCH TO THIS ONE STATE: 1e. Default search is for debtor. Check here to request a secured party search Mail to address above (C), default Pick Up at customer counter NOTE: All information on this form is public record.