UCC-11 Information Request {UCC-11}

INFORMATION REQUEST FOLLOW INSTRUCTIONS CAREFULLY A. NAME & PHONE OF CONTACT [optional] B. RETURN TO: (Name and Address) THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 1. DEBTOR NAME to be searched - insert only one debtor name (1a or 1b) - do not abbreviate or combine names 1a. ORGANIZATION'S NAME OR 1b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX 2. INFORMATION OPTIONS relating to UCC filings and other notices on file in the filing office that include as a Debtor name the name identified in item 1: 2a. SEARCH RESPONSE 2b. COPY REQUEST 2c. SPECIFIED COPIES ONLY CERTIFIED (Optional) Select one of the following two options: Select one of the following two options: ALL (Check this box to request a response that is complete, including filings that have lapsed.) ALL CERTIFIED (Optional) UNLAPSED CERTIFIED (Optional) UNLAPSED Record Number Date Record Filed ( if required) Type of Record and Additional Identifying Information (if required) 3. ADDITIONAL SERVICES: SOUTH CAROLINA SECRETARY OF STATE'S OFFICE, 1205 Pendleton Street Suite 525 Columbia, SC 29201 (04/12/2011) American LegalNet, Inc. www.FormsWorkFlow.com