Free UCC1 - South Carolina

IN LIEU OF CONTINUATION
STATE OF SOUTH CAROLINA FILING FEES: $ 8.00 - For the FIRST TWO pages $20.00 - Public Finance Transaction
$ 2.00 - For THIRD page $20.00 - Manufactured Home Transaction
$ 1.00 - For each ADDITIONAL page after the THIRD page. For each additional Debtor more than two (2), add $2.00 for each additional Debtor.

UCC FINANCING STATEMENT
FOLLOW INSTRUCTIONS CAREFULLY

A. NAME & PHONE OF CONTACT AT FILER [optional] B. SEND ACKNOWLEDGMENT TO: (Name and Address)

THE ABOVE SPACE IS 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
1c. MAILING ADDRESS

FIRST NAME

MIDDLE NAME

SUFFIX

CITY

STATE

POSTAL CODE

COUNTRY

: 1d. TAX ID #: (Organizations)

(Optional)

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

1f. JURISDICTION OF ORGANIZATION

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

FIRST NAME

MIDDLE NAME

SUFFIX

2c. MAILING ADDRESS

CITY

STATE

POSTAL CODE

COUNTRY

2d. TAX ID #: (Organizations)

(Optional)

ADD'L INFO RE ORGANIZATION DEBTOR

2e. TYPE OF ORGANIZATION

2f. JURISDICTION OF ORGANIZATION

2g. ORGANIZATIONAL ID #, if any NONE

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

FIRST NAME

MIDDLE NAME

SUFFIX

3c. MAILING ADDRESS

CITY

STATE

POSTAL CODE

COUNTRY

4. This FINANCING STATEMENT covers the following collateral:

THIS FINANCING STATEMENT IS AN "IN LIEU OF CONTINUATION" FOR THE FOLLOWING STATEMENT OF WHICH SHALL REMAIN

EFFECTIVE:

FILE DATE:

FILE NUMBER:

ORIGINAL FILING OFFICE:

5. ALTERNATIVE DESIGNATION [if applicable]: LESSEE/LESSOR CONSIGNEE/CONSIGNOR BAILEE/BAILOR SELLER/BUYER This FINANCING STATEMENT is to be filed [for record] (or recorded) in the REAL 6. 7. REQUEST SEARCH REPORT(S) ON UCC11 FORM
ESTATE RECORDS. Attach Addendum [if applicabl

AG. LIEN All Debtors

NON-UCC FILING Debtor 1 Debtor 2

8. OPTIONAL FILER REFERENCE DATA

SC SECRETARY OF STATE'S OFFICE, P.O. BOX 11350, COLUMBIA, SC 29211

(5/14/2003)