UCC FINANCING STATEMENT AMENDMENTFOLLOW INSTRUCTIONS (front and back) CAREFULLYA. NAME & PHONE OF CONTACT AT FILER [optional] B. SEND ACKNOWLEDGMENT TO: (Name and Address)
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
1a. INITIAL FINANCING STATEMENT FILE # 1b.This FINANCING STATEMENT AMENDMENT is
to be filed [for record] (or recorded) in theREAL 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 INFORMATION6a. ORGANIZATION’S NAME
OR
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 names7a. ORGANIZATION’S NAME
OR
7b. INDIVIDUAL’S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 7c. MAILING ADDRESS CITY STATEHHHPOSTAL CODE COUNTRY 7d. SEE INSTRUCTIONS ADD’L INFO RE
ORGANIZATION DEBTOR7e. TYPE OF
ORGANIZATION 7f. JURISDICTION OF ORGANIZATION 7g. ORGANIZATIONAL ID #, if any NONE8. 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.
9a. ORGANIZATION’S NAME
OR
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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