(a) Initial financing statement form. A filing
office that accepts written records may not refuse to accept a
written initial financing statement in the following form and
format except for a reason set forth in RCW 62A.9A-516(b):
| UCC FINANCING STATEMENT | ||||||||||||
| 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 ONLY |
||||||||||||
| 1. | DEBTOR'S EXACT FULL LEGAL NAME - insert only one debtor name (1a or 1b) - do not abbreviate or combine names | |||||||||||
| 1a. | ORGANIZATION'S NAME | |||||||||||
| OR | ||||||||||||
| 1b. | INDIVIDUAL'S LAST NAME | FIRST NAME | MIDDLE NAME | SUFFIX |
||||||||
| 1c. | MAILING ADDRESS | CITY | STATE | POSTAL CODE | COUNTRY |
|||||||
| 1d. TAX ID #: SSN OR EIN |
ADD'L INFO RE ORGANIZATION DEBTOR |
1e. TYPE OF ORGANIZATION |
1f. JURISDICTION OF ORGANIZATION |
1g. ORGANIZATIONAL ID #, If any |
NONE |
|||||||
| 2. | ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only one debtor name (2a or 2b) - do not abbreviate or combine names | |||||||||||
| 2a. | ORGANIZATION'S NAME | |||||||||||
| OR | ||||||||||||
| 2b. | INDIVIDUAL'S LAST NAME | FIRST NAME | MIDDLE NAME | SUFFIX |
||||||||
| 2c. | MAILING ADDRESS | CITY | STATE | POSTAL CODE | COUNTRY |
|||||||
| 2d. TAX ID #: SSN OR EIN |
ADD'L INFO RE ORGANIZATION DEBTOR |
2e. TYPE OF ORGANIZATION |
2f. JURISDICTION OF ORGANIZATION |
2g. ORGANIZATIONAL ID #, If any |
NONE |
|||||||
| 3. | SECURED PARTY'S NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR S/P) - insert only one secured party name (3a or 3b) | |||||||||||
| 3a. | ORGANIZATION'S NAME | |||||||||||
| OR | ||||||||||||
| 3b. | INDIVIDUAL'S LAST NAME | FIRST NAME | MIDDLE NAME | SUFFIX |
||||||||
| 3c. | MAILING ADDRESS | CITY | STATE | POSTAL CODE | COUNTRY |
|||||||
| 4. | This FINANCING STATEMENT covers the following collateral: | |||||||||||
| 5. | ALTERNATIVE DESIGNATION [if applicable]: | LESSEE/LESSOR | CONSIGNEE/CONSIGNOR | |||||||||
| BAILEE/BAILOR | SELLER/BUYER | AG. LIEN | NON-UCC FILING |
|||||||||
| 6. | This FINANCING STATEMENT is to be filed [for record] (or recorded) in the REAL ESTATE RECORDS. Attach Addendum [if applicable] |
|||||||||||
| 7. | Check to REQUEST SEARCH REPORT(S) on Debtor(s) | All Debtors | Debtor 1 | Debtor 2 | ||||||||
| [Additional Fee] [optional] |
||||||||||||
| 8. | OPTIONAL FILER REFERENCE DATA |
|||||||||||
| NATIONAL UCC FINANCING STATEMENT (FORM UCC1) (REV. 07/29/98) |
||||||||||||
| 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 | |||||||||||
| OR | ||||||||||||
| 9b. | INDIVIDUAL'S LAST NAME | FIRST NAME | MIDDLE NAME | SUFFIX |
||||||||
| 10. | MISCELLANEOUS: | |||||||||||
| THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY |
||||||||||||
| 11. | ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only one name (11a or 11b) - do not abbreviate or combine names | |||||||||||
| 11a. | ORGANIZATION'S NAME | |||||||||||
| OR | ||||||||||||
| 11b. | INDIVIDUAL'S LAST NAME | FIRST NAME | MIDDLE NAME | SUFFIX |
||||||||
| 11c. | MAILING ADDRESS | CITY | STATE | POSTAL CODE | COUNTRY |
|||||||
| 11d. TAX ID #: SSN OR EIN |
ADD'L INFO RE ORGANIZATION DEBTOR |
11e. TYPE OF ORGANIZATION |
11f. JURISDICTION OF ORGANIZATION |
11g. ORGANIZATIONAL ID #, If any |
NONE |
|||||||
| 12. | ADDITIONAL SECURED PARTY'S or ASSIGNOR S/P'S NAME - insert only one name (12a or 12b) | |||||||||||
| 12a. | ORGANIZATION'S NAME | |||||||||||
| OR | ||||||||||||
| 12b. | INDIVIDUAL'S LAST NAME | FIRST NAME | MIDDLE NAME | SUFFIX |
||||||||
| 12c. | MAILING ADDRESS | CITY | STATE | POSTAL CODE | COUNTRY |
|||||||
| 13. | This FINANCING STATEMENT covers timber to be cut or as-extracted collateral, or is filed as a fixture filing. |
16. Additional collateral description: |
||||||||||
| 14. | Description of real estate: | |||||||||||
| 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. 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 |
||||||||||||
| NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) (REV. 07/29/98) |
||||||||||||
| 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 ONLY |
|||||||||||
| 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: Give current record
name in item 6a or 6b; also give new name (if name
changed) in item 7a or 7b and/or new address (if address
change) in item 7c. |
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 7d-7g (if
applicable). |
|||||||||
| 6. | CURRENT RECORD INFORMATION: | ||||||||||
| 6a. | ORGANIZATION'S NAME | ||||||||||
| OR | |||||||||||
| 6b. | INDIVIDUAL'S LAST NAME | FIRST NAME | MIDDLE NAME | SUFFIX |
|||||||
| 7. | CHANGED (NEW) OR ADDED INFORMATION: | ||||||||||
| 7a. | ORGANIZATION'S NAME | ||||||||||
| OR | |||||||||||
| 7b. | INDIVIDUAL'S LAST NAME | FIRST NAME | MIDDLE NAME | SUFFIX |
|||||||
| 7c. | MAILING ADDRESS | CITY | STATE | POSTAL CODE | COUNTRY |
||||||
| 7d. TAX ID #: SSN OR EIN |
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. | ||||||||||
| 9a. | ORGANIZATION'S NAME | ||||||||||
| OR | |||||||||||
| 9b. | INDIVIDUAL'S LAST NAME | FIRST NAME | MIDDLE NAME | SUFFIX |
|||||||
| 10. | OPTIONAL FILER REFERENCE DATA |
||||||||||
| NATIONAL UCC FINANCING STATEMENT AMENDMENT (FORM UCC3) (REV. 07/29/98) |
|||||||||||
| UCC FINANCING STATEMENT AMENDMENT ADDENDUM | |||||||||||
| FOLLOW INSTRUCTIONS (front and back) CAREFULLY |
|||||||||||
| 11. | INITIAL FINANCING STATEMENT FILE # (same as item 1a on Amendment form) |
||||||||||
| 12. | NAME OF PARTY AUTHORIZING THIS AMENDMENT (same as item 9 on Amendment form) |
||||||||||
| 12a. | ORGANIZATION'S NAME | ||||||||||
| OR | |||||||||||
| 12b. | INDIVIDUAL'S LAST NAME | FIRST NAME | MIDDLE NAME | SUFFIX |
|||||||
| 13. | Use this space for additional information |
||||||||||
| THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY |
|||||||||||
| NATIONAL UCC FINANCING STATEMENT AMENDMENT ADDENDUM (FORM UCC3Ad) (REV. 07/29/98) |
|||||||||||
[2000 c 250 § 9A-521.]