Standard UCC Financing Statement Addendum
15. Name and address of a RECORD OWNER of above-described real estate
(if Debtor does not have a record interest):
17. Check only if applicable and check only one box.
Debtor is a
Trust or Trustee acting with respect to property held in trust or
Decedent's Estate
18. Check only if applicable and check only one box.
FILING OFFICE COPY UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 05/22/02)
Debtor is a TRANSMITTING UTILITY
Filed in connection with a Manufactured-Home Transaction effective 30 years
Filed in connection with a Public-Finance Transaction effective 30 years
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
FIRST NAME
CITY
STATE
11e. TYPE OF ORGANIZATION
COUNTRY
11. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only one name (11a or 11b) - do not abbreviate or combine names
11c. MAILING ADDRESS
OR
11a. ORGANIZATION'S NAME
11b. INDIVIDUAL'S LAST NAME
11d. SEE INSTRUCTIONS
11f. JURISDICTION OF ORGANIZATION
MIDDLE NAME
POSTAL CODE
SUFFIX
ADD'L INFO RE
ORGANIZATION
DEBTOR
NONE
12. ADDITIONAL SECURED PARTY'S or ASSIGNOR S/P'S NAME - insert only one name (12a or 12b)
OR
14. Description of real estate:
fixture filing.
12c. MAILING ADDRESS CITY
STATE
SUFFIX
MIDDLE NAMEFIRST NAME12b. INDIVIDUAL'S LAST NAME
12a. ORGANIZATION'S NAME
collateral, or is filed as a
13. This FINANCING STATEMENT covers
timber to be cut or
as-extracted 16. Additional collateral description:
11g. ORGANIZATIONAL ID #, if any
POSTAL CODE COUNTRY
OR
UCC FINANCING STATEMENT ADDENDUM
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT
9a. ORGANIZATION'S NAME
9b. INDIVIDUAL'S LAST NAME
10. MISCELLANEOUS:
MIDDLE NAME,SUFFIX
FIRST NAME
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