Form Ucc-3 - Uniform Commercial Code - State Of Connecticut
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1FORM UCCS / UNIFORM
COMMERCIAL
CODE/STATE
OF CONNECTICUT
PLEASE TYPE OR PRINT - SEE REVERSE SIDE FOR COMPLETE
INSTRUCTION
WC-3
Rev. 3/97
SPACE FOR OFFICE USE ONLY
SPACE FOR OFFICE USE ONLY
WORK ORDER NUMBER
FILING NUMBER
TYPE OF FILING - Place a check mark next to the appropriate
selection.
a. Continuation:
The financing statement
between the parties named below and bearing the number indrcated in item 3 is continued for a subsequent
term.
b. Amendment:
The financing statement
bearing the number indicated in item 3 IS amended as set forth in item 7
c. Assignment:
The secured party assigns to the assignee named below rights established
under the financing statement
bearing the number indicated in item 3.
d. Partial Assignment:
The secured party assigns to the assignee named below rights established
under the financing statement
bearing the number indicated in item 3
to the extend stated in item 7.
e. Partial Release:
The secured party releases the property set fourth in item 7 from the collateral presented in the original financing statement
bearing the number
indicated in item 3.
f.
Termination:
The secured party no longer claims a security interest under the financing statement bearing the number indicated in item 3.
THIS STATEMENT
REFERS TO THE ORIGINAL
FINANCING
STATEMENT
NO.
DEBTOR’S
FULL LEGAL NAME - Attach 8% x 11” sheet to present addrtional debtor informatron.
LAST NAME
FIRST NAME
INDIVIDUAL
NAME
BUSINESS
17 Check here for additional
debtors.
MIDDLE NAME
SUFFIX
S.S. NUMBER
TAXPAYER
I.D. #
IAILING ADDRESS
(Street or P.O. Box)
ITY
STATE
COUNTRY
POSTAL CODE
SECURED
PARTY’S
FULL LEGAL NAME - Attach 8% x 11” sheet to present addrtronal secured party InformatIon.
LAST NAME
FIRST NAME
INDIVIDUAL
0
Check here for additional secured party
NAME
BUSINESS
i
I
IAILING ADDRESS
(Street or P.O. Box)
ITY
STATE
COUNTRY
POSTAL CODE
(IF APPLICABLE)
ASSIGNEE’S
FULL LEGAL
NAME -Attach
8% x 11” sheet to present addrtronal assignee Information.
0
Check here for additional assignee
LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
S.S. NUMBER
INDIVIDUAL
NAME
TAXPAYER
I.D. #
BUSINESS
tAlLlNG ADDRESS
(Street or P.O. Box)
:ITY
POSTAL CODE
Use the following space and attachments
referenced
below to set fourth any information
relatrng to the selectton made in item 2 above.
IUMBER OF ADDITIONAL
SHEETS
PRESENTED
SIGNATURE(S)
OF DEBTOR(S)
SIGNATURE(S)
OF SECURED
PARTY(IES)
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Parent category: Financial