
UCC FINANCING STATEMENT AMENDMENT
Filing Fee: $18
Follow Instructions Carefully
A. NAME & PHONE OF CONTACT (optional)
B. SEND ACKNOWLEDGMENT TO: (Name and Address)
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ABOVE SPACE FOR FILING OFFICE USE ONLY
1. Initial Financing Statement Information (Required)
1a. Original Filing Number: 1b. Original Filing Date: 1c. If filed prior to January 1, 2000, indicate Original Filing Office:
2. □ Termination:Effectiveness of the Financing Statement identified above is terminated with respect to security interest(s) of the Secured Party authorizing this Termination Statement.
3. □ Continuation: Effectiveness of the Financing Statement identified above with respect to security interest(s) of the Secured Party authorizing this Continuation Statement
is continued for the additional period provided by applicable law.
4. □ Assignment: Give name of assignee in item 7a or 7b and address of assignee in item 7c; also give name of assignor in item 9.
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This Amendment affects □ Debtor or □ Secured Party of record. Check only one
of these two boxes.
Also check one of the following three boxes and provide appropriate information in items 6 and/or 7.
□ CHANGE name and/or address: Give current record name in item 6a or 6b; also give □ DELETE name: Give record name
□ ADD name: Complete item 7a or 7b, and also
new name (if name change) in item 7a or 7b and/or new address (if address change) in item 7c.
to be deleted in 6a or 6b.
item 7c; also complete items 7e-7g (if applicable
6. CURRENT RECORD INFORMATION:
6a. ORGANIZATION'S NAME
OR
6b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX
7. CHANGED (NEW) OR ADDED INFORMATION:
7a. ORGANIZATION'S NAME
OR
7b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX
7c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY
ADD'L INFO RE 7e. TYPE OF ORGANIZATION 7f. JURISDICTION OF ORGANIZATION 7g. ORGANIZATION ID#, if any
ORGANIZATION
DEBT
R □ N
NE
8. AMENDMENT (COLLATERAL CHANGE): check only one box.
Describe collateral □ deleted or □ added, or give entire □ restated collateral description, or describe collateral □ assigned
9. NAME OF SECURED PARTY OF RECORD AUTHORIZING THIS AMENDMENT
name of assi
nor, if this is an Assi
nment
. If this is an Amendment authorized b
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9a. ORGANIZATION'S NAME
OR
9b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX
10. OPTIONAL FILER REFERENCE DATA
NATIONAL UCC FINANCING STATEMENT AMENDMENT (FORM UCC3) - COLORADO (REV 7/18/2007)