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FINANCING STATEMENT

We’ve prepared a bundle of letter templates to be used in general business situation. Feel free to use them with our compliments. However we ask that you do not reproduce these templates on any medium for public display or re-sale.

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                    FINANCING STATEMENT

____________________________________________________________
Debtor (Last Name First/Individual)    Identification Number
____________________________________________________________
Mailing Address              City, State            Postcode
____________________________________________________________
Additional Debtor - (If Any)            Tax I.D. No.
____________________________________________________________
Mailing Address              City, State            Postcode
____________________________________________________________
Debtor's Trade Names or Styles            Federal Tax Number
____________________________________________________________
Secured Party                            Tax I.D. No.
Name                                     Federal Tax No. or
Address                                  Bank Transit and
City, State                              A.B.A. No.
Postcode
____________________________________________________________
Assignee of Secured Party                Tax I.D. No.
Name                                     Federal Tax No. or
Address                                  Bank Transit and
City, State                              A.B.A. No.
Postcode
____________________________________________________________
This FINANCING STATEMENT covers the following types or
items of property (include description of real property
on which located and owner of record when required).

____________________________________________________________
Products of Collateral are also covered Yes ______No______
____________________________________________________________
Debtor is a "Transmitting Utility"      Yes ______No______
____________________________________________________________
                                             Date:
Signature(s) of Debtor(s)
_____________________________________________________________
Type or Print Name of Debtor
_____________________________________________________________
Signature(s) of Secured Party(ies)
_____________________________________________________________
Type or Print Name of Secured Party
_____________________________________________________________
Return Copy to:

_____________________________________________________________

© R. P. Emery & Associates – www.rpemery.com

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