Effective Financing Statement

For Office Use Only Wyoming Secretary of State 2020 Carey Avenue, Suite 700 Cheyenne, WY 82002-0020 Ph. 307.777.7311 Email: UCC@wyo.gov Revised May 2018 Wyoming EFS Filing Page 1 of 2 Effective Financing Statement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merican LegalNet, Inc. www.FormsWorkFlow.com Revised May 2018 Wyoming EFS Filing Page 2 of 2 General Instructions: Please type this form. Verify all information you enter for accuracy and correct spelling. Any error may result in your lien becoming ineffective. Lien Duration: An EFS lien is effective for a period of five years unless extended by filing a continuation statement Acknowledgement Letter: A system derived acknowledgement letter will be returned to you to retain with your records. Please verify the information appearing on the acknowledgement letter for accuracy and correct spelling. If you discover a problem, please contact our office immediately at (307) 777.7311. Fees: ! $20 which includes the termination. ! $40 if more than two (2) pages. Sections 2 and 3: Debtor Information Debtor Name (2a or 2b, 3a or 3b): Enter only one Debtor name per section. The debtor name can be an organization or Debtor Address (2c or 3c): Organization Debtor: organization; a sole proprietorship is not an organization, even if it does business under a trade name. If the Debtor is a partnership, enter exact full legal name of partnership. If Debtor is a registered organization (e.g., corporation, limited debtor correct name. Individual Debtor: operating under a trade name. Do not use prefixes (Mr., Mrs., Ms.). Use suffix box only for titles of lineage (Jr., Sr., III) and not for otheand all additional given names in the Middle Name box. Section 4: Secured Party Information Secured Party and Assignee: The secured party is required to file the lien notice. If the secured party is an assignee, please check the box. Secured Party Name (4a or 4b): name in either 1e or 2e but do not complete both fields. Secured Party Address (4c): Section 5: Farm Product Information Farm Product: You must list the specific farm product such as wheat, barley, hay, cattle, horses, and pigs. The listing all Code: Reference the farm product codes below and enter the applicable code. Year: For a crop grown in soil, list the calendar year in which it is harvested or to be harvested. For animals, list the calendar year in which they are born or acquired. For poultry or eggs, list the calendar year in which they are sold or to Description/Location in County: Number of bushels, head of livestock, or other commonly used identifier. Specify the units. Example: 300 bushels of winter wheat stored in bin 12. If left blank, then all specific farm products owned by the debtor are covered. County Code: List where the farm product is produced and/or located. American LegalNet, Inc. www.FormsWorkFlow.com