Update To Existing UCC Subscription

Wyoming Secretary of State Update to Existing UCC/EFS E-Filing Subscription Revised May 2018 Wyoming E - Filing System Update Page 1 of 1 1. General Information a. Organization Name b. Address c. City d. State e. Postal Code f. Name of Primary Contact Person g. Primary Contact Telephone Number h. Primary Contact Email Address: 2 . User Information a. Please provide the following information for each user to be updated in this subscription. Be sure to indicate the reason for the change. NOTE: If you already have ten (10) active users associated to your subscription, you must remove a user(s) prior to adding new ones. 1) First Name: Middle Initial: Last Name: Primary Contact? Email Address: Change Reason: Remove the User Add the user Update existing user 2) First Name: Middle Initial: Last Name: Primary Contact? Email Address: Change Reason: Remove the User Add the user Update existing user 3) First Name: Middle Initial: Last Name: Primary Contact? Email Address: Change Reason: Remove the User Add the user Update existing user 4) First Name: Middle Initial: Last Name: Primary Contact? Email Address: Change Reason: Remove the User Add the user Update existing user 5) First Name: Middle Initial: Last Name: Primary Contact? Email Address: Change Reason: Remove the User Add the user Update existing user 3 . Authorization The following individual is duly authorized by the Subscriber and is authorized to sign on behalf of the Subscriber. This form must be manually signed. Original Signature of Authorized Individual Printed Name of Signatory Signatory Title Date of Signature IMPORTANT: If information related to the PAD account needs updating, please use the attached 223Application for Prepaid Account / Amend Prepaid Account224 form. Once completed, the form can be emailed to the email address appearing at the top. American LegalNet, Inc. www.FormsWorkFlow.com