Instructions for National Correction Statement (Form UCC5)
Please type or laser-print this form. Be sure it is completely legible. Read all Instructions, especially Instructions 1a and 1b; correct identification of the initial
Record to which this Correction Statement relates is crucial. Follow Instructions completely.
Fill in form very carefully. If you have questions, consult your attorney. 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.
When properly completed, send Filing Office Copy to filing office. If you want an acknowledgment, complete item B and, if filing in a filing office that returns
an acknowledgment copy furnished by filer, you may also send Acknowledgment Copy; otherwise detach. Always detach Debtor and Secured Party Copies.
A. To assist filing offices that might wish to communicate with filer, filer may provide information in item A. This item is optional.
B. Complete item B if you want an acknowledgment sent to you. If filing in a filing office that returns an acknowledgment copy furnished by filer, present
simultaneously with this form a carbon or other copy of this form for use as an acknowledgment copy.
General You must always complete items 1 and 4 and either 2a or 2b. You
may also be required to complete item 3.
1a. Indicate type of Record to which this Correction Statement relates (e.g.,
Financing Statement or Amendment). You may also insert additional
information that you believe will assist in identifying the Record (e.g., the
filing date and/or record number of the Record).
1b. File number: Enter file number of initial financing statement to which the
Record that is the object of this Correction Statement relates. Enter only
one file number.
2. If this Correction Statement is filed based on the filer's belief that the
Record identified in item 1 is inaccurate, check box 2a, provide the basis
for that belief, and indicate the manner in which the Record should be
amended to cure the inaccuracy.
If this Correction Statement is filed based on the filer's belief that the
Record identified in item 1 was wrongfully filed, check box 2b and provide
the basis for that belief.
3. If this Correction Statement relates to a Record filed [or recorded] in a
filing office described in Section 9-501(a)(1) and this Correction Statement
is filed in such a filing office, provide the date [and time] on which the Initial
Financing Statement identified in item 1b above was filed [or recorded].
4. Always enter name of the person who authorized the filing of this
Correction Statement. This name must be the same as the name under
which the Record is indexed.
