Free Acrobat Distiller, Job 2 - Colorado

COLORADO UCC FINANCING STATEMENT
Filing Fee: $18 Follow Instructions Carefully
A. NAME & PHONE OF CONTACT (optional) B. SEND ACKNOWLEDGMENT TO: (Name and Address) [ ]

[

] ABOVE SPACE 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 ADD'L INFO RE ORGANIZATION DEBTOR 1e. TYPE OF ORGANIZATION

CITY 1f. JURISDICTION OF ORGANIZATION

STATE

POSTAL CODE

COUNTRY

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 2c. MAILING ADDRESS ADD'L INFO RE ORGANIZATION DEBTOR 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 3c. MAILING ADDRESS FIRST NAME CITY MIDDLE NAME STATE POSTAL CODE SUFFIX COUNTRY NONE 2e. TYPE OF ORGANIZATION FIRST NAME CITY 2f. JURISDICTION OF ORGANIZATION MIDDLE NAME STATE POSTAL CODE SUFFIX COUNTRY

2g. ORGANIZATIONAL ID #, if any

4. This FINANCING STATEMENT covers the following collateral:

5. ALTERNATIVE DESIGNATION (if applicable): 6. ESTATE RECORDS 8. OPTIONAL FILER REFERENCE DATA

LESSEE/LESSOR CONSIGNEE/CONSIGNOR BAILEE/BAILOR SELLER/BUYER AG LIEN NON-UCC FILING

This FINANCING STATEMENT is to be filed (for record) in the REAL

NATIONAL UCC FINANCING STATEMENT (FORM UCC1) - COLORADO (REV 7/18/2007)