Form Ucc-1 - Uniform Commercial Code - Financing Statement
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1PLEASETYPEORPRINT-SEEREVERSESIDEFORCOMPLETEINSTRUCTION
SPACE FOR OFFICE
USE ONLY
SPACE FOR OFFICE USE ONLY
WORK ORDER NUMBER
FILING
NUMBER
SPECIAL
DEBTOR/COLLATERAL
INFORMATION
- CHECK AND COMPLETE
IF APPLICABLE
-
a.
Debtor is a transmitting utility as defined in section 42a-9-402 of the Connecticut General Statutes.
-
b.
Debtor does not have an interest of record. The name of the owner of such interest is
-
c.
Products of collateral are claimed and thus covered.
-
d.
(The Collateral is crops) The below described crops are growing or are to be grown on: (describe the real estate below or on a separate sheet).
-
e.
(The below goods are to become fixtures) Describe the real estate below or on a separate sheet and file a financing statement on real estate records.
-
f.
Party named in secured party block is a LESSOR and party named in debtor block is LESSEE.
-
r3.
Party named in secured party block is a CONSIGNOR
and party named in debtor block 1s CONSIGNEE.
, DEBTOR’S
EXACT
LEGAL
NAME - Attach 8 l/2” x I I” sheet to present additional debtor informanon.
0 Check here for additional debtors.
LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
S.S. NUMBER
: INDIVIDUAL
NAME
TAXPAYER
I.D. #
IF BUSINESS
AILING ADDRESS (Street or P.O. Box)
CITY
STATE
COUNTRY
POSTAL CODE
, SECURED PARTY’S
FULL LEGAL
NAME _ Attach 8 112” x II” sheet to present additional secured party tnformation in conformity with the statement below.
LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
S.S. NUMBER
: INDIVIDUAL
NAME
IF BUSINESS
IAILING
ADDRESS (Street or P.O. Box)
CITY
STATE
TAXPAYER
I.D. #
COUNTRY
POSTAL CODE
. (IF APPLICABLE)
ASSIGNEE’S
FULL LEGAL
NAME
LAST NAME
FIRST NAME
: INDIVIDUAL
NAME
IF BUSINESS
IAILING
ADDRESS (Street or P.O. Box)
CITY
ST.&TE
. THIS FINANCING
STATEMENT
COVERS THE FOLLOWING
TYPES (or items) OF PROPERTY
(Describe).
MIDDLE
NAME
SUFFIX
S.S. NUMBER
TAXPAYER I.D. #
COUNTRY
POSTAL CODE
(UMBER
OF ADDITIONAL
SHEETS
PRESENTED
SIGNATURE
OF DEBTOR
(or Assignor)
SIGNATURE
OF SECURED
L’ARTY
(or
Assignee)
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Parent category: Financial