Instructions for Information Request (Form UCC11)
Please type or laser-print this form. Be sure it is completely legible. Read and follow all Instructions, especially Instruction 1; use of the correct name
for the Debtor is crucial.
Fill in form very carefully; mistakes may have important legal consequences. If you have questions, consult your attorney. The filing office cannot give
Send completed form parts 1 and 2 (labeled Filing Office Copy (1) and (2)) to the filing office, with the required fee.
Filing office may offer additional information options. Contact filing office or use form specially designed by filing office to obtain additional information
A and B. To assist filing offices that might wish to communicate with filer, filer may provide information in item A and item B. These items are optional.
C. Provide name and address of requestor in item C. This item is NOT optional.
1. Debtor’s name. Enter only one Debtor name in item 1 -- either an organization's name (1a) or an individual’s name (1b). Enter Debtor's
name. Do not abbreviate words that are not already abbreviated in the Debtor’s name.
Organization Debtor Name. “Organization Name” means the name of an entity that is not a natural person. A sole proprietorship is not an organization,
even if the individual proprietor does business under a trade name. If Debtor is a registered organization (e.g., corporation, limited partnership,
limited liability company), it is advisable to examine Debtor’s current filed public organic records to determine Debtor's correct name. Trade name
is insufficient. If a corporate ending (e.g., corporation, limited partnership, limited liability company) is part of the Debtor’s name, it must be included.
Do not use words that are not part of the Debtor’s name.
Individual Debtor Name. “Individual Name” means the name of a natural person; this includes the name of an individual doing business as a sole
proprietorship, whether or not operating under a trade name. The term includes the name of a decedent where collateral is being administered
by a personal representative of the decedent. The term does not include the name of an entity, even if it contains, as part of the entity’s name,
the name of an individual. Prefixes (e.g., Mr., Mrs., Ms.) and titles (e.g., M.D.) are generally not part of an individual name. Indications of lineage
(e.g., Jr., Sr., III) generally are not part of the individual’s name, but may be entered in the Suffix box. Enter individual Debtor’s surname (family
name) in Individual’s Surname box, first personal name in First Personal Name box, and all additional names in Additional Name(s)/Initial(s) box.
If a Debtor’s name consists of only a single word, enter that word in Individual’s Surname box and leave other boxes blank.
For both organization and individual Debtors. Do not use Debtor’s trade name, DBA, AKA, FKA, division name, etc. in place of or combined with
Debtor’s correct name; filer may add such other names as additional Debtors if desired (but this is neither required nor recommended).
2. Information Options. Information options relating to UCC filings and other notices on file in the filing office that include as a Debtor name the
name identified in item 1. Please note that it is permissible to select an option in 2a and also check an option in 2b. Check the "CERTIFIED (Optional)"
box appropriately in items 2a, 2b, or 2c.
2a. Check appropriate box in item 2a; the box "ALL" if you are requesting a search of all active records, including lapsed filings, or the box "UNLAPSED"
if you are requesting a search of only active records that have not lapsed.
2b. Check appropriate box in item 2b to request copies of records appearing on the search response; the box "ALL" if you are requesting copies of
all active records, including lapsed filings, or the box "UNLAPSED" if you are requesting copies of only active records that have not lapsed.
2c. Complete item 2c if you are ordering copies of specific records by record number.
3. Additional Services. Some filing offices offer service options in addition to those offered in item 2. These may be shown on the face of this
form or may otherwise be publicized by the particular filing office. Caution: if any of these additional service options introduces a search criterion
(e.g., limiting search to named Debtor at an address in a specified city and state) that narrows the scope of the search, this may result in an incomplete
search (that fails to list all filings against the named Debtor) and you may fail to learn information that might be of value to you.
4. Delivery Instructions. Unless otherwise instructed, filing office will mail information to the name and address in item C. Contact filing office
concerning availability of other delivery options. Check appropriate box (4a or 4b) if optional services are available from the filing office and are
4a. If information is to be picked up from the filing office, check the "Pick Up" box.
4b. For other than mail or pick up, check the "Other" box and specify the other delivery method that is being requested. If requesting delivery service,
provide delivery serivce's name and requestor's account number to bill for delivery charge. Filing office will not deliver by delivery service unless
prepaid waybill or account number for billing is provided.