Effective Financing Statement Amendment

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 Amendment Page 1 of 2 Effective Financing Statement (EFS) Amendment 1. Contact and Send Acknowledgment To: a. Name and Phone of Contact at Filer (optional) b. PAD Account # to be Charged c. Send Acknowledgement To: (Name and Address) d. Email Contact at Filer 2. Original Financing Statement Information: a . Wyoming EFS No. Date of Filing: 3. Amendment Types: Continuation ($15; $30 if > 2 pages) Continues the expiration date of the filing by 5 years. May only be filed within six (6) months of the expiration of the lien. Termination ($5 if EFS filed prior to 7/1/2001; otherwise no fee ) The secured party no longer claims a security interest. Assignment Full or Partial ($15; $30 if > 2 pages) Provide name of Assignee in item 6a or b, and address of Assignee in 6c. Assignor to sign in 5c to the property described in item 7 has been assigned to the assignee listed in item 6. Partial Release ($15; $30 if > 2 pages) The secured party release s the collateral described in item 7 below. Add Secured Party (item 6) Changed Secured Party (item 6) Delete Secured Party (item 6) ($15; $30 if > 2 pages) Add Debtor (item 6) Changed Debtor (item 6) Delete Debtor (item 6) ($15; $30 if > 2 pages) Add Collateral (item 7) Changed Collateral (item 7) Delete Collateral (item 7) ($15; $30 if > 2 pages ) 4. First Original (you must indicate additional original debtors on the addendum form) : Or a. Organization Name First Name Middle Name Suffix 5 . Original : Or a. Organization Name First Name Middle Name Suffix 6 . Changed or Added Information (only one (1) name ( 6 a or 6 b): Check if Assignee Or a. Organization Name First Name Middle Name Suffix c. Last 4 - digits of the SSN or FEIN d . Mailing Address City State Postal Code 7 . Updated Farm Product Information : Indicate Add/Change/Delete Farm Product Code Year Quantity County Code Description/Location in County American LegalNet, Inc. www.FormsWorkFlow.com Revised May 2018 Wyoming EFS Amendment 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. 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: See each amendment type for the specific fee. Section 2: Original Financing Statement Information Wyoming EFS No. and Date of Filing: You must list the initial filing number and the date the original lien was recorded with our Office. Be sure to check the number for accuracy. Please do not provide a filing number assigned to an amendment. Only one (1) filing number per form is permitted. Section 3: Amendment Types Check the appropriate box for the amendment you are performing. You must list all original debtors when filing an EFS Amendment. To do so, you will list the first debtor in Section 4 and subsequent debtors in Sections 9 and 10 on the Amendment Addendum form. You must provide the original secured party/assignee information. Section 6: Changed or Added Information an individual name or an organization name, but not both. Section 7: Updated Farm Product Information These fields are used when adding, changing, or deleting a farm product. Please indicate what the intent is. NOTE: you must list the specific farm product American LegalNet, Inc. www.FormsWorkFlow.com