UCC FINANCING STATEMENT AMENDMENT
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
A. NAME & PHONE OF CONTACT AT FILER [optional]
B. SEND ACKNOWLEDGMENT TO: (Name and Address)
THE ABOVE SPACE IS FOR FILING OFFICE USE ONL Y
1a. INITIAL FINANCING STATEMENT FILE #
1b. This FINANCING STATEMENT AMENDMENT is
to be filed [for record] (or recorded) in the
REAL ESTATE RECORDS.
2. TERMINATION: Effectiveness of the Financing Statement identified above is terminated with respect to security interest(s) of the Secured Party authorizing this Termination Statement.
3. CONTINUATION: Effectiveness of the Financing Statement identified above with respect to security interest(s) of the Secured Party authorizing this Continuation Statement is
continued for the additional period provided by applicable law.
4. ASSIGNMENT (full or partial): Give name of assignee in item 7a or 7b and address of assignee in item 7c; and also give name of assignor in item 9.
5. AMENDMENT (PARTY INFORMATION): This Amendment affects Debtor or Secured Party of record. Check only one of these two boxes.
Also check one of the following three boxes and provide appropriate information in items 6 and/or 7.
CHANGE name and/or address: Please refer to the detailed instructions in
regards to changing the name/address of a party. DELETE name: Give record name
to be deleted in item 6a or 6b. ADD name: Complete item 7a or 7b, and also item 7c;
also complete items 7e-7g (if applicable).
6. CURRENT RECORD INFORMATION
OR 6a. ORGANIZATION’S NAME
6b. INDIVIDUAL’S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
7. ADDITIONAL DEBTOR’S EXACT FULL LEGAL NAME – insert only one debtor name (7a or 7b) – do not abbreviate or combine names
OR 7a. ORGANIZATION’S NAME
7b. INDIVIDUAL’S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
7c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
7d. SEE INSTRUCTIONS
ADD’L INFO RE
ORGANIZATION
DEBTOR 7e. TYPE OF
ORGANIZATION
7f. JURISDICTION OF ORGANIZATION
7g. ORGANIZATIONAL ID #, if any
NONE
8. AMENDMENT (COLLATERAL CHANGE): check only one box.
Describe collateral deleted or added, or give entire restated collateral description, or describe collateral assigned.
9. NAME OF SECURED PARTY OF RECORD AUTHORIZING THIS AMENDMENT (name of assignor , if this is an Assignment). If this is an Amendment authorized by a Debtor which
adds collateral or adds the authorizing Debtor, or if this is a Termination authorized by a Debtor, check here and enter name of DEBTOR authorizing this Amendment.
OR 9a. ORGANIZATION’S NAME
9b. INDIVIDUAL’S LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
10. OPTIONAL FILER REFERENCE DATA
International Association of Commercial Administrators (IACA)
FILING OFFICE COPY – UCC FINANCING STATEMENT AMENDMENT (FORM UCC3) (REV. 05/22/02)
Instructions for UCC Financing Statement Amendment (Form UCC3)
Please type or laser-print this form. Be sure it is completely legible. Read all Instructions, especially Instruction 1a; correct file number of initial financing
statement is crucial. Follow Instructions completely.
Fill in form very carefully; mistakes may have important legal consequences. If you have questions, consult your attorney. Filling 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.
An Amendment may relate to only one financing statement. Do not enter more than one file number in item 1a.
When properly completed, send Filing Office Copy, with required fee, to filing office. If you want an acknowledgment, compete item B and, if filing in a filing
office that returns an acknowledgment copy furnished by filer, you may also send Acknowledgment Copy; otherwise detach. Always detach Debtor
and Secured Party Copies.
If you need to use attachments, you are encouraged to use either Amendment Addendum (Form UCC3Ad) or Amendment Additional Party (Form UCC3AP).
Always complete items 1a and 9 .
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 a carbon or other copy of this form for use as an acknowledgment copy.
1a. File number: Enter file number
of initial financing statement to
which this Amendment relates.
Enter only one file number. In
some states, the file number is
not unique; in those states, also
enter in item 1a, after the file
number, the date that the initial
financing statement was filed.
1b. Only if this Amendment is to be
filed or recorded in the real
estate records, check box 1b
and also, in item 13 of
Amendment Addendum, enter
Debtor's name, in proper format
exactly identical to the format of
item 1 of financing statement,
and name of record owner if
Debtor does not have a record
interest.
Note: Show purpose of this
Amendment by checking box 2,3, 4, 5
(in item 5 you must check two boxes)
or 8; also complete items 6, 7 and/or 8
as appropriate. Filer may use this
Amendment form to simultaneously
accomplish both data changes (items
4, 5, and/or B) and a Continuation (item
3), although in some states filer may
have to pay a separate fee for each
purpose.
2. To terminate the effectiveness of
the identified financing
statement with respect to
security interest(s) of authorizing
Secured Party, check box 2.
See Instruction 9 below.
3. To continue the effectiveness of
the identified financing
statement with respect to
security interest(s) of authorizing
Secured Party, check box3.
See Instruction 9 below.
4. To assign (i) all of assignor's
interest under the identified
financing statement, or (ii) a
partial interest in the security
interest covered by the identified
financing statement, or (iii)
assignor's full interest in some
(but not all) of the collateral
covered by the identified
financing statement: Check box
in item 4 and enter name of
assignee in item7a if assignee is
an organization, or in item 7b,
formatted as indicated, if
assignee is an individual.
Complete 7a or 7b, but not both.
Also enter assignee's address in
item 7c. Also enter name of
assignor in item 9. If partial
Assignment affects only some
(but not all) of the collateral
covered by the identified
financing statement, filer may
check appropriate box in item 8
and indicate affected collateral
in item 8. 5,6,7. To change the name of a
party: Check box in item 5 to
indicate whether this
Amendment amends
information relating to a
Debtor or a Secured Party;
also check box in item 5 to
indicate that this is a name
change; also enter name of
affected party (current record
name) in item 6a or 6b as
appropriate; and enter new
name (7a or 7b). If the new
name refers to a Debtor
complete (7c); also complete
7e-7g if 7a was completed.
5,6,7. To change the address of a
party: Check box in item 5 to
indicate whether this
Amendment amends
information relating to a
Debtor or a Secured Party;
also check box in item 5 to
indicate that this is an address
change; also enter name of
affected party (current record
name) in item 6a or 6b as
appropriate; and enter new
address (7c) in item 7.
5,6,7. To change the name and
address of a party: Check box
in item 5 to indicate whether
this Amendment amends
information relating to a
Debtor or a Secured Party;
also check box in item 5 to
indicate that this is a
name/address change; also
enter name of affected party
(current record name) in items
6a or 6b as appropriate; and
enter the new name (7a or
7b). If the new name refers to
a Debtor complete item 7c;
also complete 7e-7g if 7a was
completed.
5,6. To delete a party: Check box
in item 5 to indicate whether
deleting a Debtor or a Secured
Party; also check box in item
S to indicate that this is a
deletion of a party; and also
enter name (6a or 6b) of
deleted party in item 6.
5,7. To add a party: Check box in
item 5 to indicate whether
adding a Debtor or Secured
Party; also check box in item 5
to indicate that this is an
addition of a party and enter
the new name (7a or 7b). If
the new name refers to a
Debtor complete item 7c; also
complete 7e-7g if 7a was
completed. To include further
additional Debtors or Secured
Parties, attach Amendment
Additional Party (Form
UCC3AP), using correct name
format.
Note : The preferred method
for filing against a new Debtor (an individual or organization
not previously of record as a
Debtor under this file number)
is to file a new Financing
Statement (UCC1) and not an
Amendment (UCC3).
7d. Reserved for Financing
Statement Amendments to be
filed in North Dakota or South
Dakota only. If this Financing
Statement Amendment is to
be filed in North Dakota or
South Dakota, the Debtor’s
taxpayer identification number
(tax ID#) — social security
number or employer
identification number must be
placed in this box.
8. Collateral change . To change
the collateral covered by the
identified financing statement,
describe the change in item 8.
This may be accomplished
either by describing the
collateral to be added or
deleted, or by setting forth in
full the collateral description
as it is to be effective after the
filing of this Amendment,
indicating clearly the method
chosen (check the appropriate
box). If the space in item 8 is
insufficient, use item 13 of
Amendment Addendum (Form
UCC3Ad). A partial release of
collateral is a deletion. If, due
to a full release of all
collateral, filer no longer
claims a security interest
under the identified financing
statement, check box 2
(Termination) and not box 8
(Collateral Change). If a partial
assignment consists of the
assignment of some (but not
all) of the collateral covered by
the identified financing
statement, filer may indicate
the assigned collateral in item
8, check the appropriate box
in item 8, and also comply with
instruction 4 above.
9. Always enter name of party of
record authorizing this
Amendment; in most cases,
this will be a Secured Party of
record. If more than one
authorizing Secured Party,
give additional name(s),
properly formatted, in item 13
of Amendment Addendum
(Form UCC3Ad). If the
indicated financing statement
refers to the parties as lessee
and lessor, or consignee and
consignor, or seller and buyer,
instead of Debtor and Secured
Party, references in this
Amendment shall be deemed
likewise so to refer to the
parties. If this is an
assignment, enter assignor's
name. If this is an Amendment
authorized by a Debtor that
adds collateral or adds a
Debtor, or if this is a Termination authorized by a
Debtor, check the box in
item 9 and enter the name,
properly formatted, of the
Debtor authorizing this
Amendment, and, if this
Amendment or Termination
is to be filed or recorded in
the real estate records, also
enter, in item 13 of
Amendment Addendum,
name of Secured Party of
record.
10. This item is optional and is
for filer's use only. For filer's
convenience of reference,
filer may enter in item 10
any identifying information
(e.g., Secured Party's loan
number, law firm file
number, Debtor's name or
other identification, state in
which form is being filed,
etc.) that filer may find
useful.
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