Free Business Services Database Requests - Minnesota

Minnesota Secretary of State UCC Database Standing Order Request
This form must be submitted with a signed license agreement

Company name:________________________________________

Date: ______________

Contact Person ____________________________________ Phone number _____________________

Address _____________________________________City _______________ State_____ Zip ________

Will pick up

Return by UPS

Return by Courier _________________/_________________ name account number Check Items Ordering FEE on CDROM $12,000.00

FILE DESCRIPTION

UCC Financing and Tax Lien statement database only (does not include images) UPDATES
DATABASE updates NOTE: a debit account is required for updates. Please list your account number below. IMAGE updates NOTE: a debit account is required for updates. Please list your account number below Weekly Monthly Weekly Monthly

$250.00 $1,000.00 $125.00 $500.00

TOTAL
MEDIA Choose format for data from the reverse side Format CD-Rom

Payment Method OSS account number _______________________ Debit my ACH account Payment enclosed ============================================================================

ORDERING INSTRUCTIONS
Weekly updates contain data from Monday at 12:01am to Midnight on Sunday. They are available for pick up by no later than Wednesday afternoon of each week at our Empire Drive location. Electronic media is available the following formats: A. B. C. FXCS FIXED CHARACTER POSITION TRAILING SPACES INCLUDED TFC FIXED CHARACTER POSITION, TABSET SEPARATED, TRAILING SPACES TRUNCATED CSQ COMMA SEPARATED ENCLOSED IN QUOTES

See our WEB site at www.sos.state.mn.us under Business Center; Other Services; Purchase UCC Data for samples of these formats. ==================================================================================== The database files are in ASCII TEXT Images are in a TIF format Please list your format choice on the front of this form. All standing orders require a running balance be maintained in an account with the Secretary of State's Office or a registration of ACH (electronic payment) for use as a payment method. The ability to register for ACH as a payment method is available from our homepage www.sos.state.mn.us by clicking on Business Center; Forms & Fees; Miscellaneous Information & Forms. To order the UCC Financing Statement and Tax Lien database you must sign the UCC Database License Agreement. The license agreement can be obtained by calling 651-296-2803 or 1-877-551-6767. Please send this completed form along with the signed license agreement to: Minnesota Secretary of State - UCC Retirement Systems of Minnesota Building 60 Empire Drive, Suite 100 St. Paul, MN 55103

If you have any questions regarding the purchase of the UCC Financing Statement and Tax Lien database, please call 651-296-2803 or 1-877-551-6767 for assistance. All of the information on this form is public. Minnesota law requires certain information to be provided for this type of filing. If that information is not included, your document may be returned unfiled. This document can be made available in alternative formats, such as large print, Braille or audio tape, by calling (651)296-2803/voice. For a TTY/TTD (deaf and hard of hearing) communication, contact the Minnesota Relay Service at 1-800-627-3529 and ask them to place a call to (651)296-2803. The Secretary of State's Office does not discriminate on the basis of race, creed, color, sex, sexual orientation, national origin, age, marital status, disability, religion, reliance on public assistance or political opinions or affiliations in employment or the provision of service.
BulkRequestUCC10/08