Form Ucc3 PDF Details

In order to file a UCC3 form, you will need to provide specific information about the secured party and the collateral. The first step is to determine whether or not you are eligible to file a UCC3. To do this, you will need to review the state’s requirements. In some states, there is a requirement that the debtor be given notice of the filing. The debtor may also have an opportunity to object to the filing. If you are eligible and decide to proceed with filing a UCC3, it is important to make sure that all of the information is complete and accurate. Any errors can result in delays or even rejection of your filing. So, what exactly goes into a UCC3 form? Let’s take a closer look.

QuestionAnswer
Form NameForm Ucc3
Form Length5 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 15 sec
Other namesucc3 alabama ucc financing statement form

Form Preview Example

UCCFINANCINGSTATEMENTAMENDMENT

FOLLOW INSTRUCTIONS (front and back) CAREFULLY

A.NAME&PHONEOFCONTACTATFILER[optional]

B. SEND ACKNOWLEDGMENT TO: (Name and Address)

THEABOVESPACEISFORFILINGOFFICEUSEONLY

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

 

 

DELETE name: Give record name

 

ADD name: Complete item 7a or 7b, and also

 

 

 

 

 

 

 

name (if name change) in item 7a or 7b and/or new address (if address change) in item 7c.

 

 

to be deleted in item 6a or 6b.

 

item 7c; also complete items 7d-7g (if applicable).

6.CURRENT RECORD INFORMATION: 6a. ORGANIZATION'S NAME

OR

 

 

 

 

6b. INDIVIDUAL'S LAST NAME

FIRSTNAME

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

7e.TYPEOFORGANIZATION

7f.JURISDICTIONOFORGANIZATION

7g. ORGANIZATIONAL ID #, if any

 

 

 

 

 

 

 

 

 

ORGANIZATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DEBTOR

 

 

 

 

 

 

 

 

 

 

 

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.NAMEOF SECURED PARTYOF 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.OPTIONALFILERREFERENCEDATA

 

 

 

FILINGOFFICECOPY—NATIONALUCCFINANCINGSTATEMENTAMENDMENT(FORMUCC3)(REV.07/29/98)

UCCFINANCINGSTATEMENTAMENDMENT

FOLLOW INSTRUCTIONS (front and back) CAREFULLY

A.NAME&PHONEOFCONTACTATFILER[optional]

B. SEND ACKNOWLEDGMENT TO: (Name and Address)

THEABOVESPACEISFORFILINGOFFICEUSEONLY

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

 

 

DELETE name: Give record name

 

ADD name: Complete item 7a or 7b, and also

 

 

 

 

 

 

 

name (if name change) in item 7a or 7b and/or new address (if address change) in item 7c.

 

 

to be deleted in item 6a or 6b.

 

item 7c; also complete items 7d-7g (if applicable).

6.CURRENT RECORD INFORMATION: 6a. ORGANIZATION'S NAME

OR

 

 

 

 

6b. INDIVIDUAL'S LAST NAME

FIRSTNAME

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

7e.TYPEOFORGANIZATION

7f.JURISDICTIONOFORGANIZATION

7g. ORGANIZATIONAL ID #, if any

 

 

 

 

 

 

 

 

ORGANIZATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DEBTOR

 

 

 

 

 

 

 

 

 

 

 

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.NAMEOF SECURED PARTYOF 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.OPTIONALFILERREFERENCEDATA

ACKNOWLEDGMENTCOPY—NATIONALUCCFINANCINGSTATEMENTAMENDMENT(FORMUCC3)(REV.07/29/98)

UCCFINANCINGSTATEMENTAMENDMENT

FOLLOW INSTRUCTIONS (front and back) CAREFULLY

A.NAME&PHONEOFCONTACTATFILER[optional]

B. SEND ACKNOWLEDGMENT TO: (Name and Address)

THEABOVESPACEISFORFILINGOFFICEUSEONLY

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

 

 

DELETE name: Give record name

 

ADD name: Complete item 7a or 7b, and also

 

 

 

 

 

 

 

name (if name change) in item 7a or 7b and/or new address (if address change) in item 7c.

 

 

to be deleted in item 6a or 6b.

 

item 7c; also complete items 7d-7g (if applicable).

6.CURRENT RECORD INFORMATION: 6a. ORGANIZATION'S NAME

OR

 

 

 

 

6b. INDIVIDUAL'S LAST NAME

FIRSTNAME

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

7e.TYPEOFORGANIZATION

7f.JURISDICTIONOFORGANIZATION

7g. ORGANIZATIONAL ID #, if any

 

 

 

 

 

 

 

 

 

ORGANIZATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DEBTOR

 

 

 

 

 

 

 

 

 

 

 

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.NAMEOF SECURED PARTYOF 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.OPTIONALFILERREFERENCEDATA

 

 

 

DEBTORCOPY—NATIONALUCCFINANCINGSTATEMENTAMENDMENT(FORMUCC3)(REV.07/29/98)

UCCFINANCINGSTATEMENTAMENDMENT

FOLLOW INSTRUCTIONS (front and back) CAREFULLY

A.NAME&PHONEOFCONTACTATFILER[optional]

B. SEND ACKNOWLEDGMENT TO: (Name and Address)

THEABOVESPACEISFORFILINGOFFICEUSEONLY

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

 

 

DELETE name: Give record name

 

ADD name: Complete item 7a or 7b, and also

 

 

 

 

 

 

 

name (if name change) in item 7a or 7b and/or new address (if address change) in item 7c.

 

 

to be deleted in item 6a or 6b.

 

item 7c; also complete items 7d-7g (if applicable).

6.CURRENT RECORD INFORMATION: 6a. ORGANIZATION'S NAME

OR

 

 

 

 

6b. INDIVIDUAL'S LAST NAME

FIRSTNAME

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

7e.TYPEOFORGANIZATION

7f.JURISDICTIONOFORGANIZATION

7g. ORGANIZATIONAL ID #, if any

 

 

 

 

 

 

 

 

 

ORGANIZATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DEBTOR

 

 

 

 

 

 

 

 

 

 

 

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.NAMEOF SECURED PARTYOF 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.OPTIONALFILERREFERENCEDATA

SECUREDPARTYCOPY—NATIONALUCCFINANCINGSTATEMENTAMENDMENT(FORMUCC3)(REV.07/29/98)

Instructions for National 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

statementiscrucial. FollowInstructionscompletely.

Fillinformverycarefully;mistakesmayhaveimportantlegalconsequences. Ifyouhavequestions,consultyourattorney. Filingofficecannotgivelegaladvice.

Donotinsertanythingintheopenspaceintheupperportionofthisform;itisreservedforfilingofficeuse.

AnAmendmentmayrelatetoonlyonefinancingstatement. Donotentermorethanonefilenumberinitem1a.

Whenproperlycompleted,sendFilingOfficeCopy,withrequiredfee,tofilingoffice. Ifyouwantanacknowledgment,completeitemBand,iffilinginafiling

officethatreturnsanacknowledgmentcopyfurnishedbyfiler,youmayalsosendAcknowledgmentCopy,otherwisedetach. AlwaysdetachDebtorand

SecuredPartyCopies.

Ifyouneedtouseattachments,use8-1/2X11inchsheetsandputatthetopofeachsheet:“AMENDMENT”andthefilenumberoftheinitialfinancingstatement

towhichthisAmendmentrelates;youareencouragedtouseAmendmentAddendum(FormUCC3Ad).

Alwayscompleteitems1aand9.

A.Toassistfilingofficesthatmightwishtocommunicatewithfiler,filermayprovideinformationinitemA. Thisitemisoptional.

B.CompleteitemBifyouwantanacknowledgmentsenttoyou. Iffilinginafilingofficethatreturnsanacknowledgmentcopyfurnishedbyfiler,presentsimultaneously withthisformacarbonorothercopyofthisformforuseasanacknowledgmentcopy.

1a. Filenumber:Enterfilenumberofinitialfinancingstatementtowhichthis Amendmentrelates. Enteronlyonefilenumber. Insomestates,thefile numberisnotunique;inthosestates,alsoenterinitem1a,afterthefile number,thedatethattheinitialfinancingstatementwasfiled.

1b. OnlyifthisAmendmentistobefiledorrecordedintherealestaterecords, check box 1b and also, in item 13 of Amendment Addendum, enter Debtor’sname,inproperformatexactlyidenticaltotheformatofitem1 offinancingstatement,andnameofrecordownerifDebtordoesnothave arecordinterest.

Note: ShowpurposeofthisAmendmentbycheckingbox2,3,4,5(initem5 you must check two boxes) or 8; also complete items 6, 7 and/or 8 as appropriate. FilermayusethisAmendmentformtosimultaneouslyaccomplish bothdatachanges(items4,5,and/or8)andaContinuation(item3),although insomestatesfilermayhavetopayaseparatefeeforeachpurpose.

2.Toterminatetheeffectivenessoftheidentifiedfinancingstatementwith respecttosecurityinterest(s)ofauthorizingSecuredParty,checkbox2. SeeInstruction9below.

3.Tocontinuetheeffectivenessoftheidentifiedfinancingstatementwith respecttosecurityinterest(s)ofauthorizingSecuredParty,checkbox3. SeeInstruction9below.

4.To assign (i) all of assignor’s interest under the identified financing statement,or(ii)apartialinterestinthesecurityinterestcoveredbythe identifiedfinancingstatement,or(iii)assignor’sfullinterestinsome(but not all) of the collateral covered by the identified financing statement: Checkboxinitem4andenternameofassigneeinitem7aifassigneeis anorganization,orinitem7b,formattedasindicated,ifassigneeisan 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 Assignmentaffectsonlysome(butnotall)ofthecollateralcoveredbythe identifiedfinancingstatement,filermaycheckappropriateboxinitem8 andindicateaffectedcollateralinitem8.

5,6,7.Tochangethenameand/oraddressofaparty: Checkboxinitem5to indicate whether this Amendment amends information relating to a DebtororaSecuredParty;alsocheckboxinitem5toindicatethatthis is a name and/or address change; also enter name of affected party (current record name, in case of name change) in items 6a or 6b as appropriate;andalsogivenewname(7aor7b)and/ornewaddress(7c) initem7.

5,6. To delete a party: Check box in item 5 to indicate whether deleting a DebtororaSecuredParty;alsocheckboxinitem5toindicatethatthis isadeletionofaparty;andalsoentername(6aor6b)ofdeletedpartyin item6.

5,7. Toaddaparty: Checkboxinitem5toindicatewhetheraddingaDebtor or Secured Party; also check box in item 5 to indicate that this is an additionofaparty;alsoenterallrequiredinformationinitem7:name(7a or 7b)and address(7c); also, if addinga Debtor,tax ID# (7d) in those states where required, and additional organization Debtor information (7e-g)ifaddedDebtorisanorganization. Note: Thepreferredmethod forfilingagainstanewDebtor(anindividualororganizationnotpreviously of record as a Debtor under this file number) is to file a new Financing Statement(UCC1)andnotanAmendment(UCC3).

8.Collateral change. To change the collateral covered by the identified financing statement, describe the change in item 8. This may be accomplishedeitherbydescribingthecollateraltobeaddedordeleted,or bysettingforthinfullthecollateraldescriptionasitistobeeffectiveafter thefilingofthisAmendment,indicatingclearlythemethodchosen(check theappropriatebox). Ifthespaceinitem8isinsufficient,useitem13of AmendmentAddendum(FormUCC3Ad). Apartialreleaseofcollateralis adeletion. If,duetoafullreleaseofallcollateral,filernolongerclaimsa security interest under the identified financing statement, check box 2 (Termination)andnotbox8(CollateralChange). Ifapartialassignment consistsoftheassignmentofsome(butnotall)ofthecollateralcovered by the identified financing statement, filer may indicate the assigned collateralinitem8,checktheappropriateboxinitem8,andalsocomply withinstruction4above.

9.AlwaysenternameofpartyofrecordauthorizingthisAmendment;inmost cases,thiswillbeaSecuredPartyofrecord. Ifmorethanoneauthorizing SecuredParty,giveadditionalname(s),properlyformatted,initem13of 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, referencesinthisAmendmentshallbedeemedlikewisesotorefertothe parties. If this is an assignment, enter assignor's name. If this is an AmendmentauthorizedbyaDebtorthataddscollateraloraddsaDebtor, orifthisisaTerminationauthorizedbyaDebtor,checktheboxinitem9 and enter the name, properly formatted, of the Debtor authorizing this Amendment, and, if this Amendment or Termination is to be filed or recordedintherealestaterecords,alsoenter,initem13ofAmendment Addendum,nameofSecuredPartyofrecord.

10.Thisitemisoptionalandisforfiler'suseonly. Forfiler'sconvenienceof reference, filer may enter in item 10 any identifying information (e.g., SecuredParty'sloannumber,lawfirmfilenumber,Debtor'snameorother identification, state in which form is being filed, etc.) that filer may find useful.