UCC1 Financing Statement {UCC1}

UCC FINANCING STATEMENT UCC-1 FOLLOW INSTRUCTIONS A. NAME & PHONE OF CONTACT AT FILER (optional) B. E-MAIL CONTACT AT FILER (optional) C. SEND ACKNOWLEDGMENT TO: (Name and Address) THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY 1. DEBTOR'S NAME: Provide only one Debtor name (1a or 1b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name); if any part of the Individual Debtor's name will not fit in line 1b, leave all of item 1 blank, check here 1a. ORGANIZATION'S NAME and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad) OR 1b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S)/INITIAL(S) SUFFIX 1c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY 2. DEBTOR'S NAME: Provide only one Debtor name (2a or 2b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name); if any part of the Individual Debtor's name will not fit in line 2b, leave all of item 2 blank, check here 2a. ORGANIZATION'S NAME and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad) OR 2b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S)/INITIAL(S) SUFFIX 2c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY 3. SECURED PARTY'S NAME (or NAME of ASSIGNEE of ASSIGNOR SECURED PARTY): Provide only one Secured Party name (3a or 3b) 3a. ORGANIZATION'S NAME OR 3b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S)/INITIAL(S) SUFFIX 3c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY 4. COLLATERAL: This financing statement covers the following collateral: 5. Check only if applicable and check only one box: Collateral is 6a. Check only if applicable and check only one box: Public-Finance Transaction held in a Trust (see UCC1Ad, item 17 and Instructions) being administered by a Decedent's Personal Representative 6b. Check only if applicable and check only one box: A Debtor is a Transmitting Utility Consignee/Consignor Seller/Buyer Agricultural Lien Bailee/Bailor Non-UCC Filing Licensee/Licensor Lessee/Lessor Manufactured-Home Transaction 7. ALTERNATIVE DESIGNATION (if applicable): 8. OPTIONAL FILER REFERENCE DATA: SOUTH CAROLINA SECRETARY OF STATE'S OFFICE, 1205 Pendleton Street, Suite 525, Columbia, SC 29201 7/1/2013 Instructions for UCC Financing Statements (UCC-1, UCC-1AD, UCC-3, UCC-3AD, UCC-5, and UCC-11) Failure to follow all instructions may result in the rejection of your filing 1. You must type or laser print this form. 2. You must use the current forms made available through our website. 3. Individual payment must accompany each filing. We are not able to use one check for multiple filings. 4. To receive an acknowledgement* of your filing you must complete the "Send Acknowledgement To" section on the filing form and either: a. For email acknowledgement: Submit a completed "Filing Submission" form with each document listing your email address, or b. For mailed acknowledgement: Enclose a self-addressed stamped envelope. * An acknowledgement of your filing is not a copy of your filing. Customers may request a copy of a filing by using the UCC-11 form or by performing a search through the online system. All online filers will receive an email acknowledgement copy of their actual filing. 5. Send completed documents with the filing submission form and all applicable fees to: SC Secretary of State's Office -UCC Division 1205 Pendleton Street, Suite 525 Columbia, SC 29201 Please fill in the form very carefully; mistakes may have important legal consequences. If you have questions, consult your attorney. The filing office cannot give legal advice. Do not insert anything in the open space in the upper portion of this form; it is reserved for filing office use. Please do not put your Social Security number on the form - UCC filings are public records. American LegalNet, Inc. www.FormsWorkFlow.com Instructions for UCC Financing Statement (Form UCC1) Please type or laser-print this form. Be sure it is completely legible. Read and follow all Instructions, especially Instruction 1; 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. Send completed form and any attachments to the filing office, with the required fee. ITEM INSTRUCTIONS A and B. To assist filing offices that might wish to communicate with filer, filer may provide information in item A and item B. These items are optional. C. Complete item C if filer desires an acknowledgment sent to them. If filing in a filing office that returns an acknowledgment copy furnished by filer, present simultaneously with this form the Acknowledgment Copy or a carbon or other copy of this form for use as an acknowledgme nt copy. 1. Debtor's name. Carefully review applicable statutory guidance about providing the debtor's name. Enter only one Debtor name in item 1 -- either an organization's name (1a) or an individual's name (1b). If any part of the Individual Debtor's name will not fit in line 1b, check the box in item 1, leave all of item 1 blank, check the box in item 9 of the Financing Statement Addendum (Form UCC1Ad) and enter the Individual Debtor name in item 10 of the Financing Statement Addendum (Form UCC1Ad). Enter Debtor's c orrect name. Do not abbreviate words that are not already abbreviated in the Debtor's name. If a portion of the Debtor's name consists of only an initial or an abbreviation rather than a full word, enter only the abbreviation or the initial. If the collateral is held in a trust and the Debtor name is the name of the trust, enter trust name in the Organization's Name box in item 1a. 1a. Organization Debtor Name . "Organization Name" means the name of an entity that is not a natural person. A sole proprietorship is not an organization, even if the individual proprietor does business under a trade name. If Debtor is a registered organization (e.g., corporation, limited partnership, limited liability company), it is advisable to examine Debtor's current filed public organic records to determine Debtor's correct name. Trade name is insufficient. If a corporate ending (e.g., corporation, limited partnership, limited liability company) is part of the Debtor's name, it must be included. Do not use words that are not part of the Debtor's name. 1b. Individual Debtor Name. "Individual Name" means the name of a natural