2014 Oklahoma Statutes
Title 12A. Commercial Code
§12A-1-9-521. Uniform form of written financing statement and amendment.

UNIFORM FORM OF WRITTEN FINANCING STATEMENT AND AMENDMENT

(a) A filing office that accepts written records may not refuse to accept a written initial financing statement in the following form and format, except for a reason set forth in subsection (b) of Section 1-9-516:

UCC FINANCING STATEMENT

FOLLOW INSTRUCTIONS (front and back) CAREFULLY

A.NAME AND PHONE OF CONTACT AT FILER [optional]

________________________________________

B.SEND ACKNOWLEDGMENT TO: (Name and Address)

________________________________________

________________________________________ THE ABOVE SPACE IS FOR

________________________________________ FILING OFFICE USE ONLY

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

_______________________________________________________________

OR1b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX

_______________________________________________________________

1c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY

_______________________________________________________________

1d.TAX ID. NO.ADD'L INFO. RE1e. TYPE OF ORGANIZATION

SSN OR EINORGANIZATION DEBTOR

_______________________________________________________________

1f.JURISDICTION OF ORGANIZATION1g. ORGANIZATIONAL ID No.,

if any

_______________________________________________________[ ] 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

_______________________________________________________________

OR2b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX

_______________________________________________________________

2c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY

_______________________________________________________________

2d.TAX ID. NO.ADD'L INFO. RE2e. TYPE OF ORGANIZATION

SSN OR EINORGANIZATION DEBTOR

_______________________________________________________________

2f.JURISDICTION OF ORGANIZATION2g. ORGANIZATIONAL ID No.,

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

_______________________________________________________________

OR3b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX

_______________________________________________________________

3c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY

_______________________________________________________________

4.This FINANCING STATEMENT covers the following collateral:

_______________________________________________________________

5.ALTERNATIVE DESIGNATION [if applicable]: [ ] LESSEE/LESSOR

[ ] CONSIGNEE/CONSIGNOR [ ] BAILEE/BAILOR [ ] SELLER/BUYER

[ ] AG. LIEN [ ] NON-UCC FILING

6.[ ] This FINANCING STATEMENT is to be filed against the tract index in the REAL ESTATE RECORDS.

Attach Addendum [if applicable]

7.Check to REQUEST SEARCH REPORT(S) on Debtor(s)

[ ] All Debtors [ ] Debtor 1 [ ] Debtor 2

[ADDITIONAL FEE] [optional]

_______________________________________________________________

8.OPTIONAL FILER REFERENCE DATA

_______________________________________________________________

FILING OFFICE COPY - NATIONAL UCC FILING STATEMENT (FORM UCC 1))

[BACK OF FORM]

UCC FINANCING STATEMENT ADDENDUM

FOLLOW INSTRUCTIONS (front and back) CAREFULLY.

9.NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT

_______________________________________________________________

9a. ORGANIZATION'S NAME

_______________________________________________________________

OR9b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX

_______________________________________________________________

10.MISCELLANEOUS:

________________________________________

________________________________________ THE ABOVE SPACE IS FOR

________________________________________ FILING OFFICE USE ONLY

11.ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only one name (11a or 11b) - do not abbreviate or combine names

11a. ORGANIZATION'S NAME

_______________________________________________________________

OR11b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX

_______________________________________________________________

11c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY

_______________________________________________________________

11d.TAX ID. NO.ADD'L INFO. RE11e. TYPE OF ORGANIZATION

SSN OR EINORGANIZATION DEBTOR

_______________________________________________________________

11f.JURISDICTION OF ORGANIZATION11g. ORGANIZATIONAL ID No.,

if any

_______________________________________________________[ ] NONE

12.[ ] ADDITIONAL SECURED PARTY'S or [ ] ASSIGNOR S/P'S NAME - insert only one name (12a or 12b).

12a. ORGANIZATION'S NAME

_______________________________________________________________

OR12b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX

_______________________________________________________________

12c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY

_______________________________________________________________

13.This FINANCING STATEMENT covers [ ] timber to be cut or [ ] as-extracted collateral, or is filed as a [ ] fixture filing.

14.Description of real estate:

_______________________________________________________________

_______________________________________________________________

15.Name and address of a RECORD OWNER of the above-described real estate (if Debtor does not have record interest):

_______________________________________________________________

_______________________________________________________________

16.Additional collateral description:

_______________________________________________________________

_______________________________________________________________

17.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

18.Check only if applicable and check only one box:

[ ] Debtor is a TRANSMITTING UTILITY

[ ] Filed in connection with a Manufactured-Home Transaction - effective 30 years

[ ] Filed in connection with a Public-Finance Transaction - effective 30 years

FILING OFFICE COPY - NATIONAL UCC FILING STATEMENT

(FORM UCC 1Ad)

(b) A filing office that accepts written records for filing may not refuse to accept a written financing statement amendment in the following form, except for a reason set forth in subsection (b) of Section 1-9-516:

UCC FINANCING STATEMENT AMENDMENT

FOLLOW INSTRUCTIONS (front and back) CAREFULLY

A.NAME AND PHONE OF CONTACT AT FILER [optional]

_______________________________________________________________

B.SEND ACKNOWLEDGMENT TO: (Name and Address)

________________________________________

________________________________________ THE ABOVE SPACE IS FOR

________________________________________ FILING OFFICE USE ONLY

1a. INITIAL FINANCING STATEMENT FILE NO. __________________

1b. [ ] This FINANCING STATEMENT AMENDMENT is to be filed against the tract index in the REAL ESTATE RECORDS.

2.[ ] TERMINATION: Effectiveness of the Financing Statement identified above is terminated with respect to security interest(s) of the Secured Party authorizing this Termination Statement.

3.[ ] CONTINUATION: Effectiveness of the Financing Statement identified above with respect to security interest(s) of the Secured Party authorizing this Continuation Statement is continued for the additional period provided by applicable law.

4.[ ] ASSIGNMENT (full or partial): Give name of assignee in item 7a or 7b and address of assignee in item 7c; and also give name of assignor in item 9.

_______________________________________________________________

5.AMENDMENT (PARTY INFORMATION): This Amendment affects [ ] Debtor or [ ] Secured Party of record. Check only one of these two boxes. Also check one of the following three boxes and provide appropriate information in items 6 and/or 7.

[ ] CHANGE name and/or address: Give current record name in item 6a or 6b; also give new name (if name change) in item 7a or 7b and/or new address (if address change) in item 7c.

[ ] DELETE name: Give record name to be deleted in item 6a or 6b.

[ ] ADD name: Complete item 7a or 7b, and also item 7c; also complete items 7d-7g (if applicable).

6.CURRENT RECORD INFORMATION:

6a. ORGANIZATION'S NAME

_______________________________________________________________

OR6b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX

_______________________________________________________________

7.CHANGED (NEW) OR ADDED INFORMATION:

7a. ORGANIZATION'S NAME

_______________________________________________________________

OR7b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX

_______________________________________________________________

7c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY

_______________________________________________________________

7d.TAX ID. NO.ADD'L INFO. RE7e. TYPE OF ORGANIZATION

SSN OR EINORGANIZATION DEBTOR

_______________________________________________________________

7f.JURISDICTION OF ORGANIZATION7g. ORGANIZATIONAL ID No.,

if any

_______________________________________________________[ ] NONE

8.AMENDMENT (COLLATERAL CHANGE): check only one box

Describe collateral [ ] deleted or [ ] added, or give entire [ ] restated collateral description, or describe collateral [ ] assigned.

_______________________________________________________________

9.NAME OF SECURED PARTY OF RECORD AUTHORIZING THIS AMENDMENT (name of assignor, if this is an Assignment). If this is an Amendment authorized by a Debtor which adds collateral or adds the authorizing Debtor, or if this is a Termination authorized by a Debtor, check here [ ] and enter name of DEBTOR authorizing this Amendment.

9a. ORGANIZATION'S NAME

_______________________________________________________________

OR9b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX

_______________________________________________________________

10.OPTIONAL FILE REFERENCE DATA

_______________________________________________________________

FILING OFFICE COPY - NATIONAL UCC FINANCING STATEMENT AMENDMENT (FORM UCC3)

[BACK OF FORM]

UCC FINANCING STATEMENT AMENDMENT ADDENDUM

FOLLOW INSTRUCTIONS (front and back) CAREFULLY

11.INITIAL FINANCING STATEMENT FILE NO. (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

_______________________________________________________________

OR12b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX

_______________________________________________________________

13. USE THIS SPACE FOR ADDITIONAL INFORMATION

_________________________________________

_________________________________________THE ABOVE SPACE IS FOR

_________________________________________FILING OFFICE USE ONLY

FILING OFFICE COPY - NATIONAL UCC FINANCING STATEMENT AMENDMENT ADDENDUM (FORM UCC3Ad)

(c) A form that a filing office may not refuse to accept under subsection (a) or (b) of this section must conform to the format prescribed for the form by the National Conference of Commissioners on Uniform State Laws.

Added by Laws 2000, c. 371, § 99, eff. July 1, 2001.