UCC FINANCING STATEMENT AMENDMENT
Filing Fee: $18 Follow Instructions Carefully
A. NAME & PHONE OF CONTACT (optional) B. SEND ACKNOWLEDGMENT TO: (Name and Address) [ ]
[ 1. Initial Financing Statement Information (Required)
] ABOVE SPACE FOR FILING OFFICE USE ONLY
1a. Original Filing Number: 1b. Original Filing Date: 1c. If filed prior to January 1, 2000, indicate Original Filing Office: 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: Give name of assignee in item 7a or 7b and address of assignee in item 7c; 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 name (if name change) in item 7a or 7b and/or new address (if address change) in item 7c.
DELETE name: Give record name
to be deleted in 6a or 6b.
ADD name: Complete item 7a or 7b, and also
item 7c; also complete items 7e-7g (if applicable)
6. CURRENT RECORD INFORMATION: 6a. ORGANIZATION'S NAME OR 6b. INDIVIDUAL'S LAST NAME FIRST NAME 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 ADD'L INFO RE ORGANIZATION DEBTOR 7e. TYPE OF ORGANIZATION
CITY 7f. JURISDICTION OF ORGANIZATION
7g. ORGANIZATION ID#, if any 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. NAME OF SECURED 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
9b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX
10. OPTIONAL FILER REFERENCE DATA
NATIONAL UCC FINANCING STATEMENT AMENDMENT (FORM UCC3) - COLORADO (REV 7/18/2007)