Fillable STATE OF FLORIDA UNIFORM COMMERCIAL CODE FINANCING STATEMENT

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STATE OF FLORIDA UNIFORM COMMERCIAL CODE FINANCING STATEMENT

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STATE OF FLORIDA UNIFORM COMMERCIAL CODE
FINANCING STATEMENT FORM – ADDITIONAL PARTY
16. INITIAL FINANCING STATEMENT FILE # (same as item 1a on Amendment form)
17. NAME OF SECURED PARTY OF RECORD AUTHORIZING THIS AMENDMENT
17a. ORGANIZATION’S NAME
17b. INDIVIDUAL’S SURNAME
FIRST PERSONAL
NAME
ADDITIONAL
NAME(S)/INITIAL(S)
SUFFIX
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
18. MISCELLANEOUS:
19. ADDITIONAL DEBTOR’S EXACT FULL LEGAL NAME – INSERT ONLY ONE DEBTOR NAME (19a OR 19b) – Do Not Abbreviate or Combine Names
19.a ORGANIZATION’S NAME
19.b INDIVIDUAL’S SURNAME
FIRST PERSONAL NAME ADDITIONAL NAME(S)/INITIAL(S) SUFFIX
19.c MAILING ADDRESS Line One
This space not available.
MAILING ADDRESS Line Two
CITY STATE POSTAL CODE COUNTRY
20. ADDITIONAL DEBTOR’S
EXACT FULL LEGAL NAME – INSERT ONLY ONE DEBTOR NAME (20a OR 20b) – Do Not Abbreviate or Combine Names
20.a ORGANIZATION’S NAME
20.b INDIVIDUAL’S SURNAME
FIRST PERSONAL NAME ADDITIONAL NAME(S)/INITIAL(S) SUFFIX
20.c MAILING ADDRESS Line One
This space not available.
MAILING ADDRESS Line Two
CITY STATE POSTAL CODE COUNTRY
21. ADDITIONAL DEBTOR’S
EXACT FULL LEGAL NAME – INSERT ONLY ONE DEBTOR NAME (21a OR 21b) – Do Not Abbreviate or Combine Names
21.a ORGANIZATION’S NAME
21.b INDIVIDUAL’S SURNAME
FIRST PERSONAL NAME ADDITIONAL NAME(S)/INITIAL(S) SUFFIX
21.c MAILING ADDRESS Line One
This space not available.
MAILING ADDRESS Line Two
CITY STATE POSTAL CODE COUNTRY
22. ADDITIONAL SECURED PARTY’S NAME
or ASSIGNOR SECURED PARTY’S NAME – INSERT ONLY ONE SECURED PARTY (22a OR 22b)
22.a ORGANIZATION’S NAME
22.b INDIVIDUAL’S SURNAME
FIRST PERSONAL NAME ADDITIONAL NAME(S)/INITIAL(S) SUFFIX
22.c MAILING ADDRESS Line One
This space not available.
MAILING ADDRESS Line Two
CITY STATE POSTAL CODE COUNTRY
23. ADDITIONAL SECURED PARTY’S NAME
or ASSIGNOR SECURED PARTY’S NAME – INSERT ONLY ONE SECURED PARTY (23a OR 23b)
23.a ORGANIZATION’S NAME
23.b INDIVIDUAL’S SURNAME
FIRST PERSONAL NAME ADDITIONAL NAME(S)/INITIAL(S) SUFFIX
23.c MAILING ADDRESS Line One
This space not available.
MAILING ADDRESS Line Two
CITY STATE POSTAL CODE COUNTRY
STANDARD FORM - FORM UCC-3 AMENDMENT ADDITIONAL PARTY (REV.05/2013) Filing Office Copy Approved by the Secretary of State, State of Florida
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STATE OF FLORIDA UNIFORM COMMERCIAL CODE FINANCING STATEMENT

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Completed 13 April 2022

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