Free efs form.p65 - Wyoming

State of Wyoming Effective Financing Statement (EFS)
Debtor Name Social Security# or Employer ID# Secured Party and Address

1. ________________________ __________________________ 2. ________________________ __________________________ 3. ________________________ __________________________ Mailing Address Assignee of Secured Party and Address

CHECK (X) IF ALSO COVERED

PROCEEDS OF COLLATERAL

PRODUCTS OF COLLATERAL

Pay proceeds to debtor and secured party unless otherwise checked

Secured Party Only

Debtor Only

ATTACHMENTS

Use the following for Farm Products requiring EFFECTIVE FINANCING STATEMENT (EFS) filing in accordance with the Food Security Act of 1985.
FARM PRODUCT CODE YEAR QUANTITY COUNTY CODE LOCATION IN COUNTY OR FURTHER DESCRIPTION

________________________________________________

______________________________________________
MUST BE ORIGINALLY SIGNED Signature of Secured Party

_____________________________________________________

_____________________________________________________ MUST BE ORIGINALLY SIGNED Signature of Debtor(s)

FOR TERMINATION ONLY: To use Acknowledgment as a Termination Statement, Secured Party must date and sign below: Termination Statement dated: _________________________ Signed: ____________________________
Signature of Secured Party State of Wyoming Effective Financing Statement Secretary of State, The Capitol, Cheyenne, WY 82002 (307) 777-7311

Filing fee:

$20.00 (Includes fee for termination statement) $35.00 if more than two pages

efs form.p65 Revised 6/02