STATE OF CONNECTICUT UCC-3 FINANCING STATEMENT AMENDMENT
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. INITIAL FINANCING STATEMENT FILE #
COURIER ADDRESS: Commercial Recording Division Connecticut Secretary of the State 30 Trinity Street Hartford, CT 06106 860-509-6002 Fee $25 (Space for filing office use only)
Cust ID ________________
TERMINATION: Effectiveness of the Financing Statement identified above is terminated with respect to security interest(s) of the Secured Party authorizing this Termination Statement. 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. 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. AMENDMENT (PARTY INFORMATION): This Amendment affects Debtor or Also check one of the following 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 Secured Party of record
Check Only one of these two boxes. ADD name: Complete item 7a or 7b and also item
DELETE name: Give record name
7c; 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.
also complete items 7d-7g (if applicable).
CURRENT RECORD INFORMATION 6a. ORGANIZATION'S NAME
OR 6b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX
CHANGED (NEW) OR ADDED INFORMATION: 7a. ORGANIZATION'S NAME
OR 7b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX
ADD'L INFO RE 7e. TYPE OF ORGANIZATION ORGANIZATION DEBTOR 8. AMENDMENT (COLLATERAL CHANGE): check only one box. Describe collateral deleted or added, or give entire
TAX ID# EIN
7f. JURISDICTION OF ORGANIZATION
7g. ORGANIZATIONAL ID #, OPTIONAL
restated collateral description, or describe collateral
9. NAME OF 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
OPTIONAL FILER REFERENCE DATA
FILING OFFICE COPY CONNECTICUT UCC FINANCING STATEMENT AMENDMENT (Form UCC 3)
Instructions for Connecticut UCC Financing Statement AMENDMENT (Form UCC3)
Please type or print this form. Be sure it is completely legible. Read all Instructions, especially Instruction 1a; correct file number of initial financing statement 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. An Amendment may relate to only one financing statement. Do not enter more than one file number in item 1. If you need to use attachments, use 8 ½ x11 inch sheets, properly formatted, and put at the top of each sheet : "AMENDMENT" and the file number of the initial financing statement to which this Amendment relates; you are encouraged to use Amendment Addendum (Form UCC3Ad). Always complete item 9 1. File number: Enter file number of initial financing statement to which this Amendment relates. Enter only one file number. 5, 7. To add a party: Check box in item 5 to indicate whether adding a Debtor or Secured Party; check box in item 5 to indicate that this is an addition of a party; enter all required information in item 7. Collateral change: To change the collateral covered by the identified financing statement, describe the change in item 8. This may be accomplished either by describing the collateral to be added or deleted, or by setting forth in full the collateral description as it is to be effective after the filing of this Amendment, indicating clearly the method chosen (check the appropriate box). if the space in item 8 is insufficient, use item 14 of Amendment Addendum (Form UCC3Ad). Amendment; in most cases, this will be a Secured party of record. If more than one authorizing Secured Party, give additional name(s), properly formatted, in item 14 of Amendment Addendum (Form UCC3Ad). This item is optional and is for filer's use only
Note: Show purpose of this Amendment by checking box 2, 3, 4, 5 (in item 5 you must check two boxes) or 8; also complete items 6, 7 and/or 8 as appropriate. Filer cannot use this Amendment form to simultaneously accomplish both data changes (items 4, 5 and/or 8) and a Continuation (item 3.) 2. To terminate the effectiveness of the identified financing statement with respect to security interest(s) of authorizing Secured party, check box 2. See Instruction 9 below. To continue the effectiveness of the identified financing statement with respect to security interest(s) of authorizing Secured Party, check box 3. See Instruction 9 below. To assign (i) all of assignor's interest under the identified financing statement, or (ii) a partial interest in the security interest covered by the identified financing statement , or (iii) assignor's full interest in some (but not all) of the collateral covered by the identified financing statement: Check box in item 4 and enter name of assignee in item 7a. If assignee is an organization, or in item 7b, formatted as indicated, if assignee is an individual. Complete 7a or 7b, but not both. Enter assignee's address in item 7c. Enter name of assignor in item 9. If partial Assignment affects only some (but not all) of the collateral covered by the identified financing statement, filer may check appropriate box in item 8 and indicate affected collateral in item 8. To change the name and/or address of a party; Check box in item 5 to indicate whether this Amendment amends information relating to a Debtor or a Secured Party; also check box in item 5 to indicate that this is a name and/or address change; enter name of affected party (current record name, in case of new name (7a or 7b) and/or new address (7c) in item 7. To delete a party: Check box in item 5 to indicate whether deleting a Debtor or a Secured Party; also check box in item 5 to indicate that this is a deletion of a party; also check box in item 5 to indicate that this is a deletion of a party; and also enter name (6a or 6b) of deleted party in item 6.