Free STATE OF SOUTH DAKOTA FINANCING STATEMENT - South Dakota

SOUTH DAKOTA FINANCING STATEMENT ­ UCC 3
Secretary of State 500 E. Capitol Pierre, SD 57501-5070 605-773-4422

Fees
Fee $ __________________ Account #_______________

Clear Form
HELP

CHEYENNE RIVER SIOUX TRIBE FORM

PLEASE TYPE THE INFORMATION ON THIS FORM ACCORDING TO ALL INSTRUCTIONS PRINTED ON THE BACK OF THE UCC 3 FORM NOTE: Type smaller than 8 point is not acceptable. This is an example of 8 point type. 1. SECURED PARTY NAME AND ADDRESS insert only one secured party name (1a or 1b)
1a. ORGANIZATION'S NAME or 1b. INDIVIDUAL'S LAST NAME 1c. MAILING ADDRESS FIRST NAME CITY MIDDLE NAME STATE POSTAL CODE SUFFIX COUNTRY

2. ASSIGNEE OF SECURED PARTY NAME AND ADDRESS insert only one assignee name (2a or 2b)
2a. ORGANIZATION'S NAME or 2b. INDIVIDUAL'S LAST NAME 2c. MAILING ADDRESS FIRST NAME CITY MIDDLE NAME STATE POSTAL CODE SUFFIX COUNTRY

3. DEBTOR'S EXACT FULL LEGAL NAME ­ insert only one debtor (3a or 3b) ­ do not abbreviate or combine names.
or 3a. ORGANIZATION'S NAME 3b. INDIVIDUAL'S LAST NAME 3c. MAILING ADDRESS 3d. TAX ID # SSN OR EIN
ADD'S INFO RE ORGANIZATION DEBTOR

FIRST NAME CITY 3e. TYPE OF ORGANIZATION 3f. JURSIDICTION OF ORGANIZATION

MIDDLE NAME STATE POSTAL CODE 3G. ORGANIZATIONAL ID#, if any

SUFFIX COUNTRY

NONE

4. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME ­ insert only one debtor name (4a or 4b) ­ do not abbreviate or combine names.
4a. ORGANIZATION'S NAME or 4b. INDIVIDUAL'S LAST NAME 4c. MAILING ADDRESS 4d. TAX ID # SSN OR EIN
ADD'S INFO RE ORGANIZATION DEBTOR

FIRST NAME CITY 4e. TYPE OF ORGANIZATION 4f. JURSIDICTION OF ORGANIZATION

MIDDLE NAME STATE POSTAL CODE 4G. ORGANIZATIONAL ID#, if any

SUFFIX COUNTRY

NONE

THIS STATEMENT REFERS TO ORIGINAL FINANCING STATEMENT NO. ___________________________________________________________ (limited to one transaction per UCC 3) DATE _________________________________________________ FILED WITH ________________________________________________________________________________

The financing statement bearing the above file number is still effective. Cannot be filed more than six months prior to the expiration date. Must be signed by secured party for effective financing statements. Fee: $25 and $3 for each additional debtor name

CONTINUATION

The secured party no longer claims a security interest under the financing statement bearing the above file number. Must be signed by secured party for effective financing statements. Fee: None

TERMINATION

The secured party's rights to the property described below under the statement bearing the above file number have been assigned to the assignee whose name and address are listed above. Must be signed by secured party and debtor for Effective Financing Statement. Fee: $25 and $3 for each additional debtor name

ASSIGNMENT

The financing statement bearing the above file number is amended as set forth below. Must be signed by both debtor and secured party for Effective Financing Statement.

AMENDMENT

Fee: $25 and $3 for each additional debtor name

This area is for the description of collateral, release, collateral if assigned, or description of real estate, if necessary:

Check (X) if covered:

PROCEEDS of collateral are also covered.

PRODUCTS of collateral are also covered.

Use the following spaces only for Farm Products requiring EFFECTIVE FINANCING STATEMENT (EFS)
FARM PRODUCT YEAR QUANTITY COUNTY CODE LOCATION IN COUNTY OR FURTHER DESCRIPTION

Pay proceeds to Debtor and Secured Party unless otherwise checked:

Secured Party only

Debtor only

Filed with the Secretary of State as

UCC

EFS

BOTH

Number of Additional Sheets, if any _____________________

Signature(s) of Debtor(s)

Signature of Secured Party
UCC 3 FORM Revised 07/01/2009