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202503098
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Last modified
6/9/2025 3:54:12 PM
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6/9/2025 3:54:11 PM
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202503098
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202503098 <br />UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS <br />9. NAME OF FIRST DEBTOR: Same as line la or lb on Financing Statement; if line lb was left blank <br />because Individual Debtor name did not fit, check here <br />OR <br />9a. ORGANIZATION'S NAME <br />9b. INDIVIDUAL'S SURNAME <br />Moss <br />FIRST PERSONAL NAME <br />Donna <br />L <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />10. DEBTOR'S NAME: Provide (10a or 10b) only ggg additional Debtor name or Debtor name tha did not fit in line lb or 2b of the Financing Statement (Form UCC1) (use exact, full name; <br />do not omit, modify, or abbreviate any part of the Debtor's name) and enter the mailing address in line 10c <br />10a. ORGANIZATION'S NAME <br />OR 10b. INDIVIDUAL'S SURNAME <br />INDIVIDUAL'S FIRST PERSONAL NAME <br />INDIVIDUAL'S ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />10c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />11.' ADDITIONAL SECURED PARTY'S NAME 4[ 0 ASSIGNOR SECURED PARTY'S NAME: Provide only gat name (11aor11b) <br />OR <br />11a. ORGANIZATION'S NAME <br />11b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAMES)/NITIAL(S) <br />SUFFIX <br />11c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />12. ADDITIONAL SPACE FOR ITEM 4 (Collateral): <br />13. This FINANCING STATEMENT is to be filed [for record] (or recorded) in the <br />REAL ESTATE RECORDS (if applicable) <br />15. Name and address of a RECORD OWNER of real estate described in item 16 <br />(if Debtor does not have a record interest): <br />14. This FINANCING STATEMENT: <br />covers timber to be cut ❑ covers as -extracted collateral El is filed as a fixture filing <br />16. Description of real estate: <br />Exhibit A <br />17. MISCELLANEOUS: <br />SECURED PARTY COPY— UCC FINANCING STATEMENTADDENDUM (Form UCC1Ad) (Rev. 07/01/23) <br />
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