FILING OFFICE COPY — UCC FINANCING STATEMENT ADDITIONAL PARTY (Form UCC1AP) (Rev. 08/22/11)
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
OR
UCC FINANCING STATEMENT ADDITIONAL PARTY
FOLLOW INSTRUCTIONS
18. NAME OF FIRST DEBTOR: Same as line 1a or 1b on Financing Statement; if line 1b was left blank
because Individual Debtor name did not fit, check here
18a. ORGANIZATION'S NAME
18b. INDIVIDUAL'S SURNAME
ADDITIONAL NAME(S)/INITIAL(S)
FIRST PERSONAL NAME
19. ADDITIONAL DEBTOR'S NAME: Provide only one Debtor name (19a or 19b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor’s name)
24. MISCELLANEOUS:
SUFFIX
OR
19b. INDIVIDUAL'S SURNAME
FIRST PERSONAL NAME
POSTAL CODE
19c. MAILING ADDRESS CITY
ADDITIONAL NAME(S)/INITIAL(S)
STATE
SUFFIX
COUNTRY
19a. ORGANIZATION'S NAME
22. ADDITIONAL SECURED PARTY'S NAME or ASSIGNOR SECURED PARTY'S NAME: Provide only one name (22a or 22b)
OR
22b. INDIVIDUAL'S SURNAME
FIRST PERSONAL NAME
POSTAL CODE
22c. MAILING ADDRESS CITY
ADDITIONAL NAME(S)/INITIAL(S)
STATE
SUFFIX
COUNTRY
22a. ORGANIZATION'S NAME
20. ADDITIONAL DEBTOR'S NAME: Provide only one Debtor name (20a or 20b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor’s name)
OR
20b. INDIVIDUAL'S SURNAME
FIRST PERSONAL NAME
POSTAL CODE
20c. MAILING ADDRESS CITY
ADDITIONAL NAME(S)/INITIAL(S)
STATE
SUFFIX
COUNTRY
20a. ORGANIZATION'S NAME
21. ADDITIONAL DEBTOR'S NAME: Provide only one Debtor name (21a or 21b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor’s name)
OR
21b. INDIVIDUAL'S SURNAME
FIRST PERSONAL NAME
POSTAL CODE
21c. MAILING ADDRESS CITY
ADDITIONAL NAME(S)/INITIAL(S)
STATE
SUFFIX
COUNTRY
21a. ORGANIZATION'S NAME
23. ADDITIONAL SECURED PARTY'S NAME or ASSIGNOR SECURED PARTY'S NAME: Provide only one name (23a or 23b)
OR
23b. INDIVIDUAL'S SURNAME
FIRST PERSONAL NAME
POSTAL CODE
23c. MAILING ADDRESS CITY
ADDITIONAL NAME(S)/INITIAL(S)
STATE
SUFFIX
COUNTRY
23a. ORGANIZATION'S NAME
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International Association of Commercial Administrators (IACA)
Instructions for UCC Financing Statement Additional Party (Form UCC1AP)
Please type or laser-print this form. Be sure it is completely legible. Read and follow all Instructions; 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
legal advice.
Use this form (multiple copies if needed) to continue adding additional Debtor or Secured Party names as needed when filing a UCC Financing Statement
(Form UCC1).
ITEM INSTRUCTIONS
18. Name of first Debtor. Enter name of first Debtor exactly as shown in item 1 of Financing Statement (Form UCC1) to which this Additional Party
relates. The name will not be indexed as a separate Debtor. If line 1b of the Financing Statement (Form UCC1) was left blank because the Individial
Debtor name did not fit, check the box in item 18 and enter as much of the Individual Debtor name from item 10 that will fit. The Debtor name
in this section is intended to cross-reference this Additional Party with the related Financing Statement (Form UCC1).
19-21. Additional Debtor’s name. If this Additional Party adds additional Debtors, complete items 19, 20, and 21 in accordance with Instruction 1 of
Financing Statement (Form UCC1).
22-23. Additional Secured Party’s name or Assignor Secured Party’s name. If this Additional Party form adds additional Secured Parties, complete
items 22 and 23 in accordance with Instruction 3 of Financing Statement (Form UCC1). In the case of a full assignment of the Secured Party’s
interest before the filing of this financing statement, if filer has provided the name and mailing address of the Assignee in item 3 of Financing
Statement (Form UCC1), filer may enter Assignor Secured Party’s name and mailing address in items 22 and 23.
24. Miscellaneous. Under certain circumstances, additional information not provided on the Financing Statement (Form UCC1) may be required.
Also, some states have non-uniform requirements. Use this space or attach additional page(s) and incorporate by reference in item 24 (e.g., See
Exhibit A) to provide such additional information or to comply with such requirements; otherwise, leave blank. Do not include social security
numbers or other personally identifiable information.