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This is a South Carolina form that can be used for UCC within Secretary Of State.
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UCC-3 UCC FINANCING STATEMENT AMENDMENT ADDENDUM FOLLOW INSTRUCTIONS 11. INITIAL FINANCING STATEMENT FILE NUMBER: Same as item 1a on Amendment form 12. NAME OF PARTY AUTHORIZING THIS AMENDMENT: Same as item 9 on Amendment form 12a. ORGANIZATION'S NAME OR 12b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S)/INITIAL(S) SUFFIX THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 13. Name of DEBTOR on related financing statement (Name of a current Debtor of record required for indexing purposes only in some filing offices - see Instruction item 13): Provide only one Debtor name (13a or 13b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name); see Instructions if name does not fit 13a. ORGANIZATION'S NAME OR 13b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S)/INITIAL(S) SUFFIX 14. ADDITIONAL SPACE FOR ITEM 8 (Collateral): 15. This FINANCING STATEMENT AMENDMENT: covers as-extracted collateral is filed as a fixture filing 16. Name and address of a RECORD OWNER of real estate described in item 17 (if Debtor does not have a record interest): covers timber to be cut 17. Description of real estate: 18. MISCELLANEOUS: SOUTH CAROLINA SECRETARY OF STATE'S OFFICE, 1205 Pendleton Street Suite 525 Columbia, SC 29201 (Rev. 07/01/13) Instructions for UCC Financing Statements (UCC-1, UCC-1AD, UCC-3, UCC-3AD, UCC-5, and UCC-11) Failure to follow all instructions may result in the rejection of your filing 1. You must type or laser print this form. 2. You must use the current forms made available through our website. 3. Individual payment must accompany each filing. We are not able to use one check for multiple filings. 4. To receive an acknowledgement* of your filing you must complete the "Send Acknowledgement To" section on the filing form and either: a. For email acknowledgement: Submit a completed "Filing Submission" form with each document listing your email address, or b. For mailed acknowledgement: Enclose a self-addressed stamped envelope. * An acknowledgement of your filing is not a copy of your filing. Customers may request a copy of a filing by using the UCC-11 form or by performing a search through the online system. All online filers will receive an email acknowledgement copy of their actual filing. 5. Send completed documents with the filing submission form and all applicable fees to: SC Secretary of State's Office -UCC Division 1205 Pendleton Street, Suite 525 Columbia, SC 29201 Please fill in the form very carefully; mistakes may have important legal consequences. If you have questions, consult your attorney. The filing office cannot give legal advice. Do not insert anything in the open space in the upper portion of this form; it is reserved for filing office use. Please do not put your Social Security number on the form - UCC filings are public records. American LegalNet, Inc. www.FormsWorkFlow.com Instructions for UCC Financing Statement Amendment Addendum (Form UCC3Ad) Please type or laser-print this form. Be sure it is completely legible. Read and follow all Instructions; use of the correct name for the Debtor is crucial. Fill in form very carefully; mistakes may have important legal consequences. If you have questions, consult your attorney. The filing office cannot give legal advice. ITEM INSTRUCTIONS 11. File Number. Enter file number of initial financing statement as shown in item 1a of Amendment (Form UCC3) to which this Amendment Addendum relates. Name of Authorizing Party. Enter information exactly as shown in item 9 on Amendment (Form UCC3). Name of Debtor on related Financing Statement. If this Amendment (Form UCC3) is to be filed in the real estate records or in any other filing office where the name of a current Debtor of record is required for indexing purposes, enter Debtor name in item 13a or 13b. Item 13 is intended to cross-reference the Amendment (Form UCC3) and Amendment Addendum with the related Financing Statement (Form UCC1). If more than one current Debtor, enter additional name(s) in item 14 or on additional Amendment Addendum (Form UCC3Ad). Do not use item 13 to change, add, or delete a Debtor name. Additional Space for Item 8 (Collateral). If space in item 8 of Amendment (Form UCC3) is insufficient or additional information must be provided, enter additional information in item 14 or attach additional page(s) and incorporate by reference in item 14 (e.g., See Exhibit A). Do not include social security numbers or other personally identifiable information. 12. 13. 14. 15-17. Real Estate Record Information. If this Amendment (Form UCC3) is to be filed in the real estate records, complete the required information (items 15, 16, and 17). If this Amendment (Form UCC3) covers timber to be cut, covers as-extracted collateral, and/or is filed as a fixture filing, check appropriate box in item 15. If the Debtor does not have an interest of record, enter the name and address of the record owner in item 16. Provide a sufficient description of real estate in accordance with the applicable law of the jurisdiction where the real estate is located in item 17. If space in items 16 or 17 is insufficient, attach additional page(s) and incorporate by reference in items 16 or 17 (e.g., See Exhibit A), and continue the real estate information. Do not include social security numbers or other personally identifiable information. 18. Miscellaneous. Under certain circumstances, additional information not provided on the Financing Statement Amendment (Form UCC3) may be required. Also, some states have non-uniform requirements. Use this space or attach additional page(s) and incorporate by reference in item 18 (e.g., See Exhibit A) to provide such additional information or to comply with such requirements; otherwise, leave blank. Do not include social security numbers or other personally identifiable information. American LegalNet, Inc. www.FormsWorkFlow.com