Uniform Commercial Code (Connecticut)
This is to file for a uniform commercial code in Connecticut. The form provided here is simply a sample of what the actual Form UCC-3 looks like.
FORM UCCS / UNIFORM COMMERCIAL CODE/STATE OF CONNECTICUT
PLEASE TYPE OR PRINT
WC-3
Rev. 3/97
SPACE FOR OFFICE USE ONLY
WORK ORDER NUMBER ________________________
SPACE FOR OFFICE USE ONLY
FILING NUMBER ________________________
1. 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 indicated 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.
2. THIS STATEMENT REFERS TO THE ORIGINAL FINANCING STATEMENT NO.
________________________
3. DEBTOR'S FULL LEGAL NAME - Attach 8 ½" x 11" sheet to present additional debtor information. ____ Check here for additional debtors.
INDIVIDUAL
LAST NAME ________________________
FIRST NAME ________________________
MIDDLE NAME ________________________
SUFFIX ________________________
S.S. NUMBER ________________________
BUSINESS
NAME ________________________
TAXPAYER I.D. # ________________________
MAILING ADDRESS (Street or P.O. Box) ________________________
CITY ________________________
STATE ________________________
COUNTRY ________________________
POSTAL CODE ________________________
4. SECURED PARTY'S FULL LEGAL NAME - Attach 8 ½" x 11" sheet to present additional secured party Information. ____ Check here for additional secured party
INDIVIDUAL
LAST NAME ________________________
FIRST NAME ________________________
BUSINESS
NAME ________________________
MAILING ADDRESS (Street or P.O. Box) ________________________
CITY ________________________
STATE ________________________
COUNTRY ________________________
POSTAL CODE ________________________
5. (IF APPLICABLE) ASSIGNEE'S FULL LEGAL NAME -Attach 8 ½" x 11" sheet to present additional assignee Information. ____ Check here for additional assignee
INDIVIDUAL
LAST NAME ________________________
FIRST NAME ________________________
BUSINESS
NAME ________________________
MAILING ADDRESS (Street or P.O. Box) ________________________
CITY ________________________
STATE ________________________
COUNTRY ________________________
POSTAL CODE ________________________
6. Use the following space and attachments referenced below to set fourth any information relating to the selection made in item 2 above.
________________________
NUMBER OF ADDITIONAL SHEETS PRESENTED ________________________
SIGNATURE(S) OF DEBTOR(S) ________________________
SIGNATURE(S) OF SECURED PARTY(IES) ________________________
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INSTRUCTIONS FOR FILLING OUT THIS FORM
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Please read an comply with the following itemized instructions
1. TYPE OF FILING: Select type of filing from the list provided by placing a check mark on the line preceding the appropriate entry. Please make only one selection.
2. ORIGINAL FINANCING STATEMENT NUMBER: Please provide the number of the original financing statement to which the UCC-3 is related. Be careful to supply the correct number as the UCC-3 will attach to whichever financing statement bears that number on the records of this office.
3. DEBTOR INFORMATION: Please provide debtor name(s) and distinguish on the form between debtors who are individuals and those which are business organizations. Note that address blocks apply to both individuals and businesses.
4. SECURED PARTY INFORMATION: Please provide secured party name(s) and distinguish on the form between secured parties who are individuals and those which are business organizations. Note that address blocks apply to both individuals and businesses.
5. ASSIGNEE INFORMATION: Complete only to reflect a full or partial assignment of the interest reflected in the original financing statement. Please provide assignee name(s) and distinguish on the form between assignees who are individuals and those which are business organizations. Note that address blocks apply to both individuals and businesses.
6. FILING INFORMATION: Present information pertaining to the filing type selected in item 1.) e.g., any changes of collateral, debtor name(s), secured party name(s) etc. A statement of the total number of attachments to the UCC-3 must be made under this heading.
GENERAL INFORMATION
Please note the following:
a. Pertinent signatures should be provided at the bottom of the form.
b. If additional space is needed, please attach one or more 8 1/2" x 11" piece(s) of paper and make the appropriate reference within item number 6 on the form.
c. The UCC-3 form has two parts, an original and a carbonless copy. The original will be filed and the copy returned to the filer. Please do not detach the copy.