Beruflich Dokumente
Kultur Dokumente
FOLLOW INSTRUCTIONS (front and back) CAREFULLY A. NAME & PHONE OF CONTACT AT FILER [optional]
(123) 555-1212
(Name and Address)
1. DEBTORS EXACT FULL LEGAL NAME insert only one debtor name (1a or 1b) do not abbreviate or combine names
1a. ORGANIZATIONS NAME OR 1b. INDIVIDUALS LAST NAME FIRST NAME MIDDLE NAME SUFFIX
Smith
1c. MAILING ADDRESS
John
CITY
Henry
STATE POSTAL CODE COUNTRY
P.O. Box 21
ADDL INFO RE ORGANIZATION DEBTOR 1e. TYPE OF ORGANIZATION
The City
1f. JURISDICTION OF ORGANIZATION
CA
90210
NONE
2. ADDITIONAL DEBTORS EXACT FULL LEGAL NAME insert only one debtor name (2a or 2b) do not abbreviate or combine names
2a. ORGANIZATIONS NAME OR 2b. INDIVIDUALS LAST NAME FIRST NAME MIDDLE NAME SUFFIX
CITY
STATE
POSTAL CODE
COUNTRY
3. SECURED PARTYS NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR S/P) insert only one secured party name (3a or 3b)
3a. ORGANIZATIONS NAME OR
JOHN H SMITH
3b. INDIVIDUALS LAST NAME FIRST NAME MIDDLE NAME SUFFIX
CITY
STATE
POSTAL CODE
COUNTRY
The City
CA
90210
THIS IS ACTUAL AND CONSTRUCTIVE NOTICE ALL RECORDED PROPERTY (REAL/PERSONAL) BELONGING TO THE BAILOR IS HEREBY PLACED INTO TRUST WITH THE BAILEE. ALL UN-RECORDED PROPERTY (REAL/PERSONAL) BELONGING TO THE BAILOR IS HEREBY PLACED INTO TRUST WITH THE BAILEE. ALL RELATIONS AND AGREEMENTS BETWEEN THE BAILOR AND THE BAILEE ARE COVERED IN THE FOLLOWING PRIVATE DOCUMENTS: 1) CONTRACT OF BAILMENT NO. JHS-1001-CB 2) POWER OF ATTORNEY NO. JHS-1001-PA
LESSEE/LESSOR
CONSIGNEE/CONSIGNOR
BAILEE/BAILOR
SELLER/BUYER
AG. LIEN
This FINANCING STATEMENT is to be filed [for record] (or recorded) in the REAL ESTATE RECORDS. Attach Addendum [if applicable] 8. OPTIONAL FILER REFERENCE DATA
All Debtors
FILING OFFICE COPY NATIONAL UCC FINANCING STATEMENT (FORM UCC1) CALIFORNIA (REV. 01/01/08)
OR
FIRST NAME
Smith
10. MISCELLANEOUS:
John
Henry
11. ADDITIONAL DEBTORS EXACT FULL LEGAL NAME insert only one name (11a or 11b) do not abbreviate or combine names
11a. ORGANIZATIONS NAME OR 11b. INDIVIDUALS LAST NAME FIRST NAME MIDDLE NAME SUFFIX
CITY
STATE
POSTAL CODE
COUNTRY
12.
CITY
STATE
POSTAL CODE
COUNTRY
13. This FINANCING STATEMENT covers collateral, or is filed as a 14. Description of real estate: fixture filing.
timber to be cut or
as-extracted
15. Name and address of a RECORD OWNER of above-described real estate (if Debtor does not have a record interest):
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 Decedents 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 FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) CALIFORNIA (REV. 01/01/08)