4. ADDITIONAL LIVESTOCK OWNER/SECURED PARTY NAME or
B. E-MAIL CONTACT AT FILER (optional)
FILING OFFICE COPY — UCC1- LIVESTOCK OWNER/CARETAKER FINANCING STATEMENT (Rev 02/2017)
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
South Dakota Secretary of State
UCC1- LIVESTOCK OWNER/
CARETAKER FINANCING STATEMENT
A. NAME & PHONE OF CONTACT AT FILER (optional)
OR
1b. ORGANIZATION'S NAME
POSTAL CODE
CITY1d. MAILING ADDRESS
1c. INDIVIDUAL'S SURNAME
STATE COUNTRY
8. OPTIONAL FILER REFERENCE DATA:
OR
3b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME
POSTAL CODE
3c. MAILING ADDRESS
CITY
ADDITIONAL NAME(S)/INITIAL(S)
STATE
SUFFIX
COUNTRY
3a. ORGANIZATION'S NAME
3. LIVESTOCK OWNER/SECURED PARTY NAME: Provide only one livestock owner name (3a or 3b)
5. COLLATERAL: This financing statement covers the following collateral:
C. SEND ACKNOWLEDGMENT TO: (Name and Address)
Check only if applicable:
PROCEEDS of collateral are also covered.
PRODUCTS of collateral are also covered.
OR
2b. ORGANIZATION'S NAME
POSTAL CODECITY2d. MAILING ADDRESS
2c. INDIVIDUAL'S SURNAME
STATE
SUFFIX
COUNTRY
FIRST PERSONAL NAME
ADDITIONAL NAME(S)/INITIAL(S)
SUFFIX
ADDITIONAL NAME(S)/INITIAL(S)
FIRST PERSONAL NAME
1. LIVESTOCK CARETAKER'S/DEBTOR'S EXACT FULL LEGAL NAME: Provide only one caretaker/debtor name (1b or 1c) - do not abbreviate or combine names
2. ADDITIONAL LIVESTOCK CARETAKER'S/DEBTOR'S EXACT FULL LEGAL NAME: Provide only one caretaker/debtor name (2b or 2c) - do not abbreviate or combine names
1a. TAX IDENTIFICATION NUMBER
2a. TAX IDENTIFICATION NUMBER
OR
4b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME
POSTAL CODE
4c. MAILING ADDRESS
CITY
ADDITIONAL NAME(S)/INITIAL(S)
STATE
SUFFIX
COUNTRY
4a. ORGANIZATION'S NAME
ASSIGNEE / SECURED CREDITOR OF LIVESTOCK OWNER NAME: Provide only 4a or 4b
South Dakota Secretary of State • UCC Division • 500 E. Capitol Ave • Pierre, SD 57501
Phone (605) 773-4422 • sos.ucc@state.sd.us