(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 | ||||||||
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A. | NAME & PHONE OF CONTACT AT FILER (optional) | |||||||
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B. | EMAIL CONTACT AT FILER (optional) | |||||||
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C. | SEND ACKNOWLEDGMENT TO: (Name and Address) | |||||||
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THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY | ||||||||
1. | DEBTOR'S NAME - provide only one Debtor name (1a or 1b) (use exact, full name; do not omit, modify, or abbreviate any word in the Debtor's name) | |||||||
| 1a. | ORGANIZATION'S NAME | ||||||
OR |
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| 1b. | INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME | ADDITIONAL NAME(S)/INITIAL(S) THAT ARE PART OF THE NAME OF THIS DEBTOR | SUFFIX | |||
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| 1c. | MAILING ADDRESS | CITY | STATE | POSTAL CODE | COUNTRY | ||
2. | DEBTOR'S NAME - provide only one Debtor name (2a or 2b) (use exact, full name; do not omit, modify, or abbreviate any word in the Debtor's name) | |||||||
| 2a. | ORGANIZATION'S NAME | ||||||
OR |
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| 2b. | INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME | ADDITIONAL NAME(S)/INITIAL(S) THAT ARE PART OF THE NAME OF THIS DEBTOR | SUFFIX | |||
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| 2c. | MAILING ADDRESS | CITY | STATE | POSTAL CODE | COUNTRY | ||
3. | SECURED PARTY'S NAME (or NAME of ASSIGNEE of ASSIGNOR SECURED PARTY) - provide only one secured party name (3a or 3b) | |||||||
| 3a. | ORGANIZATION'S NAME | ||||||
OR |
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| 3b. | INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME | ADDITIONAL NAME(S)/INITIAL(S) | SUFFIX | |||
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| 3c. | MAILING ADDRESS | CITY | STATE | POSTAL CODE | COUNTRY | ||
4. | COLLATERAL: This Financing Statement covers the following collateral: | |||||||
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5. | Check only if applicable and check only one box: | |||||||
Collateral is | □ held in Trust (see Instructions) |
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| □ being administered by a Decedent's Personal Representative. |
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6a. | Check only if applicable and check only one box: | |||||||
| □ Public-Finance Transaction | □ Manufactured-Home Transaction | □ A Debtor is a Transmitting Utility | |||||
6b. | Check only if applicable and check only one box: |
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| □ Agricultural Lien | □ Non-UCC Filing |
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7. | ALTERNATIVE DESIGNATION (if applicable): |
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| □ Lessee/Lessor | □ Cosignee/Cosignor | □ Seller/Buyer | □ Bailee/Bailor | □ Licensee/Licensor | |||
8. | OPTIONAL FILER REFERENCE DATA | |||||||
[UCC FINANCING STATEMENT (FORM UCC1)] (REV. 09/30/10) | ||||||||
UCC FINANCING STATEMENT ADDENDUM | ||||||||
FOLLOW INSTRUCTIONS | ||||||||
9. | NAME OF FIRST DEBTOR (same as item 1a or 1b on Financing Statement) | |||||||
| 9a. | ORGANIZATION'S NAME | ||||||
OR |
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| 9b. | INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME | ADDITIONAL NAME(S)/INITIAL(S) | SUFFIX | |||
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY | ||||||||
10. | ADDITIONAL DEBTOR'S NAME - provide only one Debtor name (10a or 10b) (use exact, full name; do not omit, modify, or abbreviate any word in the Debtor's name) | |||||||
| 10a. | ORGANIZATION'S NAME (exact, full name, without any modifications) | ||||||
OR |
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| 10b. | INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME | ADDITIONAL NAME(S)/INITIAL(S) THAT ARE PART OF THE NAME OF THIS DEBTOR | SUFFIX | |||
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| 10c. | MAILING ADDRESS | CITY | STATE | POSTAL CODE | COUNTRY | ||
11. | □ ADDITIONAL SECURED PARTY'S NAME or □ ASSIGNOR SECURED PARTY'S NAME - provide only one name (11a or 11b) | |||||||
| 11a. | ORGANIZATION'S NAME | ||||||
OR |
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| 11b. | INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME | ADDITIONAL NAME(S)/INITIAL(S) | SUFFIX | |||
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| 11c. | MAILING ADDRESS | CITY | STATE | POSTAL CODE | COUNTRY | ||
12. | ADDITIONAL SPACE FOR ITEM 4 (Collateral) |
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13. | □ This FINANCING STATEMENT is to be filed (for record) (or recorded) in the REAL ESTATE RECORDS (if applicable) |
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14. | This FINANCING STATEMENT: |
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| □ covers timber to be cut | □ covers as-extracted collateral | □ is filed as a fixture filing | |||||
15. | Name and address of a RECORD OWNER of real estate described in item 16 (if Debtor does not have a record interest) | |||||||
16. | Description of real estate | |||||||
17. | Miscellaneous | |||||||
[UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad)] (REV. 09/30/10) |
(b) Amendment form. A filing office that accepts written records may not refuse to accept a written record in the following form and format except for a reason set forth in RCW 62A.9A-516(b):
UCC FINANCING STATEMENT AMENDMENT | ||||||||
FOLLOW INSTRUCTIONS | ||||||||
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A. | NAME & PHONE OF CONTACT AT FILER (optional) | |||||||
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B. | EMAIL CONTACT AT FILER (optional) | |||||||
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C. | SEND ACKNOWLEDGMENT TO: (Name and Address) | |||||||
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THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY | ||||||||
1a. | INITIAL FINANCING STATEMENT FILE NUMBER |
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1b. | This FINANCING STATEMENT AMENDMENT is to be filed (for record) (or recorded) in the REAL ESTATE RECORDS. Filer: attach Amendment Addendum (Form UCC3 Ad) and provide Debtor's name in item 13. | |||||||
2. | □ TERMINATION: Effectiveness of the Financing Statement identified above is terminated with respect to the security interest(s) of Secured Party authorizing this Termination Statement. | |||||||
3. | □ ASSIGNMENT (full or partial): Provide name of Assignee in item 7a or 7b, and address of Assignee in item 7c and name of Assignor in item 9. For partial assignment, complete items 7 and 9 and also indicate affected collateral in item 8. | |||||||
4. | □ CONTINUATION: Effectiveness of the Financing Statement identified above with respect to the security interest(s) of Secured Party authorizing this Continuation Statement is continued for the additional period provided by applicable law. | |||||||
5. | □ PARTY INFORMATION CHANGE: Check one of these two boxes: This Change affects □ Debtor or □ Secured Party of record | |||||||
| AND | |||||||
| Check one of these three boxes to: |
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| □ CHANGE name and/or address: Complete item 6a or 6b; and item 7a or 7b and item 7c. | |||||||
| □ ADD name: Complete item 7a or 7b, and item 7c. | |||||||
| □ DELETE name: Give record name to be deleted in item 6a or 6b. | |||||||
6. | CURRENT RECORD INFORMATION: Complete for Party Information Change - provide only one name (6a or 6b) (use exact, full name; do not omit, modify, or abbreviate any word in the Debtor's name) | |||||||
| 6a. | ORGANIZATION'S NAME | ||||||
OR |
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| 6b. | INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME | ADDITIONAL NAME(S)/INITIAL(S) | SUFFIX | |||
7. | CHANGED OR ADDED INFORMATION: Complete for Assignment or Party Information Change - provide only one name (7a or 7b) (use exact full name; do not omit, modify, or abbreviate any word in the Debtor's name) | |||||||
| 7a. | ORGANIZATION'S NAME | ||||||
OR |
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| 7b. | INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME | ADDITIONAL NAME(S)/INITIAL(S) THAT ARE PART OF THE NAME OF THIS DEBTOR | SUFFIX | |||
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| 7c. | MAILING ADDRESS | CITY | STATE | POSTAL CODE | COUNTRY | ||
8. | □ COLLATERAL CHANGE: Also check one of these four boxes: | |||||||
| □ ADD collateral | □ DELETE collateral | □ RESTATE covered collateral | □ ASSIGN collateral | ||||
| Indicate collateral: |
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9. | NAME OF SECURED PARTY OF RECORD AUTHORIZING THIS AMENDMENT - provide only one name (9a or 9b) (name of assignor, if this is an Assignment). If this is an Amendment authorized by a DEBTOR, check here □ and provide name of authorizing Debtor | |||||||
| 9a. | ORGANIZATION'S NAME | ||||||
OR |
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| 9b. | INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME | ADDITIONAL NAME(S)/INITIAL(S) | SUFFIX | |||
10. | OPTIONAL FILER REFERENCE DATA | |||||||
[UCC FINANCING STATEMENT AMENDMENT (FORM UCC3)] (REV. 09/30/10) | ||||||||
UCC FINANCING STATEMENT AMENDMENT ADDENDUM | ||||||||
FOLLOW INSTRUCTIONS | ||||||||
11. | INITIAL FINANCING STATEMENT FILE NUMBER (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 |
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| 12b. | INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME | ADDITIONAL NAME(S)/INITIAL(S) | SUFFIX | |||
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY | ||||||||
13. | Name of DEBTOR on related financing statement (Name of a current Debtor of record required for indexing purposes only in some filing offices - see Instruction for item 13 - insert only one Debtor name (13a or 13b) (use exact, full name; do not omit, modify, or abbreviate any word in the Debtor's name) | |||||||
| 13a. | ORGANIZATION'S NAME | ||||||
OR |
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| 13b. | INDIVIDUAL'S SURNAME | FIRST PERSONAL NAME | ADDITIONAL NAME(S)/INITIAL(S) | SUFFIX | |||
14. | ADDITIONAL SPACE FOR ITEM 8 (Collateral) |
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15. | This FINANCING STATEMENT AMENDMENT: |
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| □ covers timber to be cut | □ covers as-extracted collateral | □ is filed as a fixture filing | |||||
16. | Name and address of a RECORD OWNER of real estate described in item 17 (if Debtor does not have a record interest) | |||||||
17. | Description of real estate | |||||||
18. | MISCELLANEOUS: | |||||||
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UCC FINANCING STATEMENT AMENDMENT ADDENDUM (FORM UCC1) (REV. 09/30/10) |
[ 2011 c 74 § 406; 2000 c 250 § 9A-521.]
NOTES:
Application--Effective date--2011 c 74: See notes following RCW 62A.9A-102.