Fill and Sign the Hours for Filing Form

State of Rhode Island and Providence Plantations Department of State - Business Services Division 148 W. River Street, Providence, Rhode Island 02904-2615 Phone: (401) 222-3040 | Email: corporations@sos.ri.gov | Website: www.sos.ri.gov Hours for filing: Public Counter: Monday – Friday 8:30 AM to 4:30 PM Online filing – 24/7 Information Requests: Information on specific filings of record with this office will not be given over the Telephone; only general information will be available. UCC11 Information Requests cannot be ordered over the telephone. All filings must be communicated in writing. Filing Fees: Filings must be communicated in writing and will not be accepted unless \ accompanied by the minimum filing fee. Checks are to be made payable to the Rhode Island Department of State. We accept VISA, MasterCard, Discover, and American Express for all over-the-counter and online transactions. A small enhanced access fee is charged for all credit card transactions. S\ ee our website for more information on enhanced access fees. Refunds: Refunds will be issued for duplicate payments and rejected documents not\ corrected within 30-days from the date the filing was submitted to this office. Refunds will not be issued for valid transactions and overpayments in th\ e amount of $10 or less. Enhanced access fees are not refundable. To request a refund or view our refund policy click here. Paper Filing Forms:The IACA National Filing Forms will be accepted for filing. Rhode Island does provide a state form for UCC11 Information Requests. Please carefully read all instructions prior to filing. Acknowledgments: Acknowledgements are no longer being mailed. If you would like to receive an Acknowledgement of your fling, you MUST provide a valid email address. Complete ITEM C of the filing form to include a valid email address. E-acknowledgements for all approved filings are emailed at 3pm and 8pm daily. Filing Evidence : If you do not receive an Acknowledgement or if you would like to obtain a copy of any recorded UCC, follow these steps: • Go to our UCC Database • To search for a UCC1 – you must search by debtor name • To search for a UCC3 – you can search by file number or debtor name • Click on the filing number to view the filing summary page • Click on the PDF link to view and print the filing Rejected Filings : Paper filers will receive their filing and payment via US mail addressed to the individual/entity that submitted the paperwork. Correspondence will accompany the paperwork indicating what steps need to be taken to correct the filling. You may also use our Rejected Filing Viewer to view the rejected document. • To search for a UCC1 – you must search by debtor name • To search for a UCC3 – you must search by file number Uniform Commercial Code (UCC) Filing Information UCC Filing Information - Revised: 11/2017 FILING OFFICE COPY — INFORMATION STATEMENT (Form UCC5) (Rev. 07/19/12) THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY INFORMATION STATEMENTFOLLOW INSTRUCTIONS A. NAME & PHONE OF CONTACT AT FILER (optional) 1. Identification of the RECORD to which this INFORMATION STATEMENT relates OR 5b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME 1a. INITIAL FINANCING STATEMENT FILE NUMBER ADDITIONAL NAME(S)/INITIAL(S) SUFFIX 5a. ORGANIZATION'S NAME 5. NAME of PERSON filing this INFORMATION STATEMENT 1b. RECORD INFORMATION TO WHICH THIS INFORMATION STATEMENT RELATES 2.Check one of these three boxes to indicate the claim made by this INFORMATION STATEMENT 3. Basis for claim of box checked in item 2 4.If this INFORMATION STATEMENT relates to a RECORD filed [or recorded] in a filing office described in Section 9-501(a)(1) and this INFORMATION STATEMENT is filed in such a filing office, provide the date [and time] on which the INITIAL FINANCING STATEMENT identified in item 1a above was filed [or recorded] 4a. DATE 4b. TIME CAUTION: This is not an amendment. C. SEND ACKNOWLEDGMENT TO: (Name and Address) B. E-MAIL CONTACT AT FILER (optional) RECORD IS INACCURATE. Enter in item 3 the basis for the belief by the Debtor of Record identified in item 5 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 2a. RECORD WAS WRONGFULLY FILED. Enter in item 3 the basis for the belief by the Debtor of Record identified in item 5 that the RECORD identified in item 1 was wrongfully filed 2b. RECORD FILED BY PERSON NOT ENTITLED TO DO SO. Enter in item 3 the basis for the belief by the Secured Party of Record that the person that filed the RECORD identified in item 1 was not entitled to do so under UCC Section 9-509 2c. Instructions for Information Statement (Form UCC5) Please type or laser-print this form. Be sure it is completely legible. Read and follow all Instructions, especially Instructions 1a and 1b; correct identification of the initial record to which this Information Statement relates is crucial. Fill in form very carefully; mistakes may have important legal consequences. If you have questions, consult your attorney. The filing office cannot give legal advice. Send completed form and any attachments to the filing office, with the required fee. Note:A person may file an Information Statement with respect to a record indexed under that person's name if the person believes the record was inaccurate or wrongfully filed, or a person may file an Information Statement with respect to a record if the person is a Secured Party of Record with respect to the financing statement to which the record relates and believes that the person that filed the record was not entitled to do so. ITEM INSTRUCTIONS A and B. To assist filing offices that might wish to communicate with filer, filer may provide information in item A and item B. These items are optional. C. Complete item C if filer desires an acknowledgment sent to them. If filing in a filing office that returns an acknowledgment copy furnished by filer, present simultaneously with this form the Acknowledgment Copy or a carbon or other copy of this form for use as an acknowledgment copy. Always complete items 1 and 5 and either 2a or 2b or 2c. Always complete item 3 with the basis for the box marked in item 2. You may also be requiredto complete item 4. 1a.File number: Enter file number of initial financing statement to which the record that is the object of this Information Statement relates. Enter only one file number. 1b. Enter record information to which this Information Statement relates. Indicate the type of record to which this Information Statement relates (e.g., Financing Statement or Amendment) or you may also insert additional information that you believe will assist in identifying the record (e.g., the record file number or the filing date of the record). 2a.Record is inaccurate. If this Information Statement is filed based upon the belief of the Debtor of Record that the record identified in item 1 is inaccurate, check box in item 2a, provide the basis for that belief in item 3, and indicate the manner in which the record should be amended to cure the inaccuracy. 2b.Record was wrongfully filed. If this Information Statement is filed based upon the belief of the Debtor of Record that the record identified in item 1 was wrongfully filed, check box in item 2b and provide the basis for that belief in item 3. 2c.Record filed by person not entitled to do so. If this Information Statement is filed based upon the belief of the Secured Party of Record that the person that filed the record identified in item 1b was not entitled to do so under Section 9-509, check box in item 2c and provide the basis for that belief in item 3. 3.Basis. Use this item to provide the basis for the box checked in item 2. 4.Filing office date and time. If this Information Statement relates to a record filed [or recorded] in a filing office described in Section 9-501(a)(1) and this Information Statement is filed in such a filing office, provide the date [and time] on which the initial financing statement identified in item 1a above was filed [or recorded]. 5.Name of Authorizing Party. Enter name of the person filing this Information Statement. This name must be the same name as a Secured Party of Record or the name under which the record is indexed.