UCC Financing Statement {UCC1} | Pdf Fpdf Doc Docx | Louisiana

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UCC Financing Statement {UCC1} | Pdf Fpdf Doc Docx | Louisiana

Last updated: 4/13/2015

UCC Financing Statement {UCC1}

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STATE OF LOUISIANA UNIFORM COMMERCIAL CODE - FINANCING STATEMENT UCC-1 Important - Read Instructions before filing out form. Follow instructions carefully. 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 (and Title of Lineage (e.g. Jr. Sr., III, if applicable) First Name Middle Name 1c Mailing Address City State Postal Code Country Add'l info re 1e Type of 1f Jurisdiction of 1g Organizational ID # if any Organization Organization Organization Debtor: 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 (and Title of Lineage (e.g. Jr., Sr. III), if applicable) First Name Middle Name 1d Tax ID #: SSN or EIN 2c Mailing Address City State Postal Code Country 2d Tax ID #: SSN or EIN 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 (and Title of Lineage (e,g. Jr., Sr., III), if applicable First Name Middle Name 3c Mailing Address City State Postal Code Country 4. This FINANCING STATEMENT covers the following collateral: 5a Check if applicable and attach legal description of real property: Fixture filing As-extracted collateral The debtor(s) do not have an interest of record in the real property (Enter name of an owner of record in 5b) 5b Owner of real property (if other than named debtor) 6a Check only if applicable and check only one box Debtor is a Transmitting Utility. Filing is Effective Until Terminated Filed in connection with a public finance transaction. Filing is effective for 30 years 6b Check only if applicable and check only one box Debtor is a Trust or Trustee acting with respect to property held in trust or Decedent's Estate 7. ALTERNATIVE DESIGNATION (If applicable): CONSIGNEE/CONSIGNOR SELLER/BUYER AG. LIEN LESSEE/LESSOR BAILEE/BAILOR NON-UCC-FILING Standing timber constituting goods 10. The space below is for Filing Office Use Only 8. Name and Phone Number to contact filer 9. Send Acknowledgment To: (Name and Address) 11. CHECK TO REQUEST SEARCH REPORT(S) ON DEBTORS (ADDITIONAL FEE REQUIRED) ALL DEBTORS DEBTOR1 DEBTOR2 LOUISIANA SECRETARY OF STATE 11/22/2010 www.FormsWorkFlow.com INSTRUCTIONS FOR LOUISIANA UCC FINANCING STATEMENT (FORM UCC 1) Please type or laser print this form. Be sure it is completely legible. Read all instructions, especially instruction 1; correct Debtor name is crucial. Follow instructions completely. Fill in form very carefully; mistakes may have important legal consequences. If you have questions, consult your attorney. Filing office cannot give legal advice. If you need to use attachments, use 8-1/2 x 11 inch sheets of paper and put at the top of each sheet the name of the first Debtor, formatted exactly as it appears in Item 1 of this form. If an Acknowledgment copy is to be returned to other than the Secured Party, please indicate the name and mailing address of the person or firm to whom the copy is to be returned in Item No. 9. If filer desires (at filer's option), check appropriate box in Item No. 11 to request Search Reports(s) on all or some of the Debtors named in this Financing Statement. The report will list all Financing Statements on file against the designated Debtor on the date of the Report: including this Financing Statement. There is an additional fee for each Report. If you have checked a box in Item No. 11, file Search Request Copy together with the Filing Officer Copy (and Acknowledgment Copy). 1. Debtor Name - Enter only one Debtor name in Item 1, (organization's name (1a) or individual's name (1b)). Enter Debtor's exact full legal name. Do not abbreviate. Organization Debtor - "Organization" means an identity having legal identity separate from its owner. A partnership is an organization; a sole proprietorship is not an organization, even if it does business under a trade name. If Debtor is a partnership enter exact full legal name of partner ship; you need not enter names of partners as additional Debtors. If Debtor is a registered organization (e.g., corporation, limited partnership, limited liability company, (it is advisable to examine Debtor's current filed charter documents to determine Debtor's correct name, organization type and jurisdiction.) Individual Debtor - "Individual" means a natural person; this includes a sole proprietorship, whether or not operating under a trade name. Don't use refixes (Mr., Mrs.) or titles (e.g., M.D.) Titles of lineage (e.g., Jr., Sr., III) are included in the last name field following the family name and preceded by a comma (Smith, Jr.). Use married woman's personal name (Mary Smith, not Mrs. John Smith). Enter individual Debtor's family name in the Last Name box (followed by a title of lineage, if applicable), first given name in First Name box and all additional given names in Middle Name box. Do not use Debtor's trade name, DBA, AKA, PKA, division names, etc. in place of or combined with Debtor's legal name; you may add such other names as additional Debtors if you wish (but this is neither required nor recommended). An address is always required for the Debtor(s) named in 1a or 1b. Louisiana law does not require Debtor's taxpayer identification number-social security or employer identification number, however; it may be required in some states. "Additional information re organization Debtor" is always required. Type of organization and jurisdiction of organization as well as Debtor's exact legal name can be determined from Debtor's current filed charter document. Organization ID#, if any, is assigned by the agency where the charter document was filed; this is different from tax ID#. This should be entered preceded by the 2-charter U.S. Postal identification of state of organization if one of the United States (e.g.. CA 12345, for California Corporation whose organization ID# is 12345. If agency does not assign organizational #, check box in Item 1g indicating "none". If an additional Debtor is included, complete Item 2, determined and formatted per instruction 1. To include further additional Debtors, or one or more additional Secured Parties, attach a 8-1/2 x 11 inch sheet of paper. Head each

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