SOUTH DAKOTA EFS 1 FINANCING STATEMENT
APPROVED STANDARD FORM
Secretary of State
500 E. Capitol Pierre, SD 57501-5070 605-773-4422
Office use only:
NOTE: Type smaller than 8 point is not acceptable. This is an example of 8 point type.
B. Name & Phone of Contact (optional)
C. E-mail Contact (optional)
D. PAD Account Number
1. DEBTOR’S NAME: Provide only one Debtor name (1a or 1b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor’s name)
or
1a. ORGANIZATION’S NAME
1b. INDIVIDUAL’S SURNAME
FIRST PERSONAL NAME
ADDITIONAL NAME(S)/INITIAL(S)
1c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
1d. TAX ID # SSN OR EIN
3. SECURED PARTY NAME: Provide only one secured party name (3a or3 b) (use exact, full name; do not omit, modify, or abbreviate any part of the secured party name)
or
3a. ORGANIZATION’S NAME
3b. INDIVIDUAL’S SURNAME
FIRST PERSONAL NAME
ADDITIONAL NAME(S)/INITIAL(S)
3c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
Signature(s) of Debtor(s)
Signature of Secured Party
2. DEBTOR’S NAME: Provide only one Debtor name (2a or 2b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor’s name)
or
2a. ORGANIZATION’S NAME
2b. INDIVIDUAL’S SURNAME
FIRST PERSONAL NAME
ADDITIONAL NAME(S)/INITIAL(S)
2c. MAILING ADDRESS
CITY
STATE
POSTAL CODE
2d. TAX ID # SSN OR EIN
4. EFFECTIVE FINANCING STATEMENT: enter the product information: Pay proceeds to Debtor and Secured Party Unless otherwise checked Debtor Secured Party
FARM PRODUCT
YEAR
QUANTITY
COUNTY CODE
LOCATION
A. Send Acknowledgment to (Name & Address):
EFS1Financing Statement Nov 2017