UCC-3 FINANCING STATEMENT AMENDMENT

(National Form - Uniform Commercial Code)

FILING OFFICE INFORMATION

ITEM 1a. INITIAL FINANCING STATEMENT FILE NUMBER

ITEM 1b. DEBTOR NAME (First Debtor on Initial Financing Statement)

Organization Debtor:

OR Individual Debtor:

ITEM 2. TYPE OF AMENDMENT

Select Amendment Type:

☐ PARTY INFORMATION CHANGE - Proceed to Section A
☐ COLLATERAL CHANGE - Proceed to Section B
☐ ASSIGNMENT (Full or Partial) - Proceed to Section C
☐ CONTINUATION - Use separate UCC-3 Continuation form
☐ TERMINATION - Use separate UCC-3 Termination form

SECTION A: PARTY INFORMATION CHANGE

Item 3. DEBTOR CHANGES

Select Change Type:

☐ ADD Debtor - New debtor authorization REQUIRED (UCC § 9-509(a))
☐ DELETE Debtor - Secured party authorization
☐ CHANGE Debtor Name - Due to name change (not assignment)
☐ CHANGE Debtor Address - Address update only

Item 4. DEBTOR BEING ADDED

Organization Debtor:

OR Individual Debtor:

Item 5. DEBTOR BEING DELETED OR CHANGED

Current Debtor Information (as on file):

Action:
☐ DELETE this Debtor entirely
☐ CHANGE to new information below

New/Changed Debtor Information:

Reason for Name Change:
☐ Legal name change (merger, conversion, amendment to charter)
☐ Correction of error on original filing
☐ Other: [EXPLAIN]

Item 6. SECURED PARTY CHANGES

Select Change Type:

☐ ADD Secured Party
☐ DELETE Secured Party
☐ CHANGE Secured Party Name/Address

Item 7. SECURED PARTY BEING ADDED/CHANGED/DELETED

Current Secured Party Information (if changing/deleting):

Action:
☐ ADD new Secured Party
☐ DELETE this Secured Party
☐ CHANGE to new information below

New/Changed Secured Party Information:

SECTION B: COLLATERAL CHANGE

Item 8. COLLATERAL AMENDMENTS

Select Collateral Change Type:

☐ ADD Collateral - Debtor authorization REQUIRED
☐ DELETE Collateral - Secured party authorization (releases security interest)
☐ RESTATE Collateral - Complete replacement of collateral description

Item 8a. COLLATERAL BEING ADDED

[DESCRIBE ADDITIONAL COLLATERAL TO BE COVERED]

Additional Collateral Categories:

☐ Accounts
☐ Chattel Paper
☐ Commercial Tort Claims
☐ Deposit Accounts
☐ Documents
☐ Equipment
☐ Farm Products
☐ Fixtures
☐ General Intangibles
☐ Goods
☐ Health-Care-Insurance Receivables
☐ Instruments
☐ Inventory
☐ Investment Property
☐ Letter-of-Credit Rights
☐ Money
☐ Supporting Obligations

Specific Description of Added Collateral:

[DETAILED DESCRIPTION OF COLLATERAL BEING ADDED]

Item 8b. COLLATERAL BEING DELETED/RELEASED

Collateral Being Released:

[DESCRIBE SPECIFIC COLLATERAL BEING RELEASED FROM SECURITY INTEREST]

Partial Release Information:
| Field | Information |
|-------|-------------|
| Reason for Release | ☐ Sale of collateral ☐ Partial payment ☐ Substitution ☐ Other: [EXPLAIN] |
| Value of Released Collateral | $[AMOUNT] |
| Remaining Secured Obligation | $[AMOUNT] |

Item 8c. RESTATED COLLATERAL DESCRIPTION

☐ Check here if this is a complete restatement of collateral

Restated Collateral Description:

[COMPLETE NEW COLLATERAL DESCRIPTION THAT REPLACES ALL PRIOR DESCRIPTIONS]

SECTION C: ASSIGNMENT

Item 9. ASSIGNMENT OF SECURED PARTY'S INTEREST

☐ FULL ASSIGNMENT - All rights transferred to Assignee
☐ PARTIAL ASSIGNMENT - Only specified rights transferred

Item 9a. NAME AND ADDRESS OF ASSIGNEE

Item 9b. SCOPE OF ASSIGNMENT

If Partial Assignment, specify collateral or rights assigned:

[DESCRIBE SPECIFIC COLLATERAL OR RIGHTS BEING ASSIGNED]

Assignment Details:
| Field | Information |
|-------|-------------|
| Effective Date of Assignment | [MM/DD/YYYY] |
| Underlying Agreement | [DESCRIBE ASSIGNMENT AGREEMENT] |
| Assignor Remains on Record | ☐ Yes ☐ No |

SECTION D: ADDITIONAL PROVISIONS

Item 10. ADDITIONAL SPACE / MISCELLANEOUS

[USE FOR ADDITIONAL INFORMATION, EXPLANATIONS, OR CONTINUATION OF ANY ITEM]

Item 11. REAL PROPERTY INFORMATION (If Applicable)

☐ This amendment relates to real-property-related collateral

Real Property Description:

[LEGAL DESCRIPTION OF REAL PROPERTY]

AUTHORIZATION CERTIFICATION

Authorization Requirements Summary:

Certification of Authorization

The undersigned certifies that:

☐ This amendment is authorized by the debtor of record (for amendments adding debtor or collateral)

☐ This amendment is authorized by the secured party of record (for amendments deleting/changing party or collateral information)

☐ The secured party of record has authorized this filing in an authenticated record

☐ A copy of the authorization is attached

FILING PARTY INFORMATION

SIGNATURE

FILING OFFICE USE ONLY

IMPORTANT NOTES

Effect of Amendment

1. Party Changes:
   - Adding a debtor: Creates a new financing statement as to that debtor (UCC § 9-512(c))
   - Deleting a debtor: Financing statement ceases to be effective as to that debtor
   - Name changes: May require new filing if debtor's name becomes seriously misleading

2. Collateral Changes:
   - Adding collateral: Perfection date for new collateral is amendment filing date
   - Deleting collateral: Releases security interest in that collateral
   - WARNING: Adding collateral starts new priority clock for that collateral

3. Assignment:
   - Assignee becomes secured party of record
   - Assignee can authorize future amendments
   - Does not affect perfection or priority

Lapse Date NOT Extended

CRITICAL: An amendment (other than a continuation statement) does NOT extend the lapse date of the initial financing statement. The financing statement will still lapse 5 years from the ORIGINAL filing date unless a proper continuation statement is filed.

Multiple Amendments

If making multiple types of changes:
- File separate amendment forms for each type, OR
- Combine changes on one form where permitted, OR
- Consult with filing office for requirements

UCC ARTICLE 9 CITATIONS

Amendment Provisions

• § 9-509: Persons entitled to file a record
• § 9-509(a): Debtor authorization required for certain filings
• § 9-509(d): Secured party authorization for other amendments
• § 9-510: Effectiveness of filed record
• § 9-512: Amendment of financing statement
• § 9-512(a): Amendment must identify initial financing statement
• § 9-512(c): Adding debtor creates new financing statement
• § 9-514: Assignment of powers of secured party of record
• § 9-516: What constitutes filing; effectiveness of filing
• § 9-521: Uniform form of written financing statement and amendment

Priority Implications

• § 9-322: Priorities among conflicting security interests
• § 9-323: Future advances
• § 9-507: Effect of certain events on effectiveness of financing statement (name changes)

CHECKLIST BEFORE FILING

☐ Correct initial financing statement file number identified
☐ Debtor name matches name on initial financing statement
☐ Amendment type properly selected
☐ All required information provided for selected amendment type
☐ Proper authorization obtained and documented
☐ Filing fee payment prepared
☐ Copy retained for records
☐ Calendar reminder set for original lapse date (amendment does not extend)
☐ Consider whether continuation statement also needed

This template follows the national UCC-3 form adopted by the International Association of Commercial Administrators (IACA). Verify compliance with state-specific requirements before filing.