Free UCC-1 Financing Statement - Connecticut

STATE OF CONNECTICUT UCC-1 FINANCING STATEMENT
MAILING ADDRESS: Commercial Recording Division Connecticut Secretary of the State P.O. BOX 150470 Hartford, CT 06115-0470 860-509-6002 Follow Instructions Carefully Requesting Party
Name Address City State Zip
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

COURIER ADDRESS: Commercial Recording Division Connecticut Secretary of the State 30 Trinity Street Hartford, CT 06106 860-509-6002

Cust ID ________________

Fee $25

(Space for filing office use only)

1c.

MAILING ADDRESS

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STATE

POSTAL CODE

COUNTRY

2.

ADD'L INFO RE 1d. TYPE OF ORGANIZATION 1e. JURISDICTION OF ORGANIZATION 1f. ORGANIZATIONAL ID # OPTIONAL ORGANIZATION DEBTOR 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.

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STATE

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3.

ADD'L INFO RE 2d. TYPE OF ORGANIZATION 2e. JURISDICTION OF ORGANIZATION 2f. ORGANIZATIONAL ID # OPTIONAL ORGANIZATION DEBTOR 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

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4. This FINANCING STATEMENT covers the following collateral:

5. ALTERNATIVE DESIGNATION (if applicable) LESSEE/LESSOR 6. OPTIONAL FILER REFERENCE DATA CONSIGNEE/CONSIGNOR BAILEE/BAILOR SELLER/BUYER

FILING OFFICE COPY ­ CONNECTICUT UCC FINANCING STATEMENT (FORM UCC1)

Revised 11/2007

Instructions for Connecticut UCC Financing Statement (Form UCC-1)
Please type or print this form. Be sure it is completely legible. Read all Instructions, especially Instruction 1; correct Debtor name is crucial. Follow Instructions completely. Fill in form very carefully; mistakes may have important legal consequences. If you have questions, consult your Legal Advisor. Filing 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. When properly completed, send Filing Office Copy, with required fee, to filing office. If you need to use attachments, use 8 ½ x11 inch sheets and put at the top of each sheet the name of the first Debtor, formatted exactly as it appears in item 2 of this form; you are encouraged to use the UCC Financing Statement Addendum. Note: If Debtor is a trust or a trustee acting with respect to property held in trust, enter Debtor's name in item 1 and attach Addendum (Form 1. Debtor name: Enter only one Debtor name in item 1, an UCC1Ad) and check appropriate box in item 11. If Debtor is a decedent's organization's name (1a) or an individual's name (1b). Enter estate, enter name of deceased individual in item 1b and attach Debtor's exact full legal name. Do not abbreviate. Addendum (Form UCC1Ad) and check appropriate box in item 11. If Debtor is a transmitting utility as defined in applicable Commercial Code, 1a. Organization Debtor. "Organization" means an entity having a legal attach Addendum (Form UCC1Ad) and check appropriate box in item 12. identity separate from its owner. A partnership is an organization; a sole proprietorship is not an organization, even if it does business 2. If an additional Debtor is included, complete item 2. To include under a trade name. If Debtor is a partnership, enter exact full legal further additional Debtors, or one or more additional Secured name of partnership; you need not enter names of partners as Parties, attach either Addendum (Form UCC1Ad) of other additional additional Debtors. If Debtor is a registered organization (e.g., page(s), using correct name format. Follow Instruction 1 for corporation, limited partnership, limited liability company), it is determining and formatting additional names. advisable to examine Debtor's current filed charter documents to determine Debtor's correct name, organization type, and jurisdiction 3. Enter information for Secured Party or Total Assignee. If there is of organization. more than one Secured Party, see Instruction 2. 1b. Individual Debtor. "Individual" means a natural person; this includes a sole proprietorship, whether or not operating under a trade name. Don't use prefixes (Mr., Mrs., Ms.). Use suffix box for titles or lineage (Jr., Sr., III) and not for other suffixes or titles (e.g., M.D.). Use married woman's personal name (Mary Smith, not Mrs. John Smith). enter individual Debtor's family name (surname) in Last Name box, first given name in First Name box, and all additional given names in Middle Name box. For both organization and individual Debtors: Don't use Debtors trade name, DBA, AKA, FKA, Division name etc. in place or combined with Debtor's legal name; you may add such other names as additional Debtors if you wish (but this is neither required nor recommended.) 1c. An address is always required for the Debtor named in 1a or 1b. 1d,e,f. Type of organization and jurisdiction of organization as well as Debtor `s exact legal name can be determined from Debtor's current filed charter document. 4. Use item 4 to indicate the collateral covered by this Financing Statement. If space in item 4 is insufficient, put the entire collateral description or continuation of the collateral description on either Addendum (Form UCC1Ad) or the other attached additional page(s). If the filer desires (at filer's option) to use titles of lessee and lessor, or consignee and consignor, or seller and buyer (in the case of accounts or chattel paper), or bailee and bailor instead of Debtor and Secured Party, check the appropriate box in item 5. This item is optional and is for filer's use only

5.

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Revised 11/2007