Nebraska Uniform Commercial Code 9-521

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9-521. Uniform form of written financing statement and amendment.

(a) A filing office that accepts written records may not refuse to accept a written initial financing statement in the following form and format except for a reason set forth in section 9-516(b):

UCC FINANCING STATEMENT

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 word in the Debtor's name)

1a. ORGANIZATION'S NAME
________________________________
OR
1b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME
________________________________ ____________________________

ADDITIONAL NAME(S)/INITIAL(S) THAT ARE
PART OF THE NAME OF THIS DEBTOR 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 word in the Debtor's name)

2a. ORGANIZATION'S NAME
________________________________
OR

2b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME
________________________________ ____________________________

ADDITIONAL NAME(S)/INITIAL(S) THAT ARE
PART OF THE NAME OF THIS DEBTOR 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 ____ held in a Trust (see Instructions)
____ being administered by a Decedent's Personal
Representative.

6a. Check only if applicable and check only one box:

____ Public-Finance Transaction

____ Manufactured-Home Transaction

____ A Debtor is a Transmitting Utility

6b. Check only if applicable and check only one box:

____ Agricultural Lien ____ Non-UCC Filing

7. ALTERNATIVE DESIGNATION (if applicable): ____ Lessee/Lessor ____ Consignee/Consignor ____ Seller/Buyer ____ Bailee/Bailor ____ Licensee/Licensor

8. OPTIONAL FILER REFERENCE DATA

________________________________________

[UCC FINANCING STATEMENT (Form UCC1)]

UCC FINANCING STATEMENT ADDENDUM

FOLLOW INSTRUCTIONS

9. NAME OF FIRST DEBTOR (same as item 1a or 1b on Financing Statement)

9a. ORGANIZATION'S NAME
________________________________
OR
9b. INDIVIDUAL'S SURNAME
________________________________
FIRST PERSONAL NAME
________________________________

ADDITIONAL NAME(S)/INITIAL(S) SUFFIX
________________________________ _____________

THE ABOVE SPACE IS FOR

FILING OFFICE USE ONLY

10. ADDITIONAL DEBTOR'S NAME - provide only one Debtor name (10a or 10b) (use exact, full name; do not omit, modify, or abbreviate any word in the Debtor's name)

10a. ORGANIZATION'S NAME
________________________________
OR

10b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME
________________________________ ____________________________

ADDITIONAL NAME(S)/INITIAL(S) THAT ARE
PART OF THE NAME OF THIS DEBTOR SUFFIX
________________________________ _____________

10c. MAILING ADDRESS
________________________________

CITY STATE POSTAL CODE COUNTRY
__________ __________ __________ __________

11. ____ ADDITIONAL SECURED PARTY'S NAME or ____ ASSIGNOR SECURED PARTY'S NAME - provide only one name (11a or 11b)

11a. ORGANIZATION'S NAME
________________________________
OR

11b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME
________________________________ ____________________________

ADDITIONAL NAME(S)/INITIAL(S) SUFFIX
________________________________ _____________

11c. MAILING ADDRESS
________________________________________

CITY STATE POSTAL CODE COUNTRY
__________ __________ __________ __________

12. ADDITIONAL SPACE FOR ITEM 4 (Collateral)

________________________________

13. ____ This FINANCING STATEMENT is to be filed [for record] (or recorded) in the REAL ESTATE RECORDS (if applicable)

14. This FINANCING STATEMENT:

_____ covers timber to be cut

_____ covers as-extracted collateral

_____ is filed as a fixture filing

15. Name and address of a RECORD OWNER of real estate described in item 16 (if Debtor does not have a record interest):

________________________________

16. Description of real estate:

________________________________

17. MISCELLANEOUS:

________________________________

[UCC FINANCING STATEMENT ADDENDUM (Form UCC1Ad)]

(b) A filing office that accepts written records may not refuse to accept a written record in the following form and format except for a reason set forth in section 9-516(b):

UCC FINANCING STATEMENT AMENDMENT

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

1a. INITIAL FINANCING STATEMENT FILE NUMBER

________________________________

1b. ____ This FINANCING STATEMENT AMENDMENT is to be filed [for record] (or recorded) in the REAL ESTATE RECORDS.

Filer: attach Amendment Addendum (Form UCC3Ad) and provide Debtor's name in item 13.

2. ____ TERMINATION: Effectiveness of the Financing Statement identified above is terminated with respect to the security interest(s) of Secured Party authorizing this Termination Statement

3. ____ ASSIGNMENT (full or partial): Provide name of Assignee in item 7a or 7b, and address of Assignee in item 7c and name of Assignor in item 9. For partial assignment, complete items 7 and 9 and also indicate affected collateral in item 8

4. ____ CONTINUATION: Effectiveness of the Financing Statement identified above with respect to the security interest(s) of Secured Party authorizing this Continuation Statement is continued for the additional period provided by applicable law

5. ____ PARTY INFORMATION CHANGE:

Check one of these two boxes:

This Change affects ____ Debtor or ____ Secured Party of record.

AND

Check one of these three boxes to:

____ CHANGE name and/or address: Complete item 6a or 6b, and item 7a or 7b and item 7c.

____ ADD name: Complete item 7a or 7b, and item 7c.

____ DELETE name: Give record name to be deleted in item 6a or 6b.

6. CURRENT RECORD INFORMATION: Complete for Party Information Change - provide only one name (6a or 6b) (use exact, full name; do not omit, modify, or abbreviate any word in the Debtor's name)

6a. ORGANIZATION'S NAME
________________________________
OR

6b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME
________________________________ ____________________________

ADDITIONAL NAME(S)/INITIAL(S) SUFFIX
________________________________ _____________

7. CHANGED OR ADDED INFORMATION: Complete for Assignment or Party Information Change - provide only one name (7a or 7b) (use exact full name; do not omit, modify, or abbreviate any word in the Debtor's name)

7a. ORGANIZATION'S NAME
________________________________
OR

7b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME
________________________________ ____________________________

ADDITIONAL NAME(S)/INITIAL(S) THAT ARE
PART OF THE NAME OF THIS DEBTOR SUFFIX
________________________________ _____________

7c. MAILING ADDRESS
________________________________________

CITY STATE POSTAL CODE COUNTRY
__________ __________ __________ __________

8. ____ COLLATERAL CHANGE:

Also check one of these four boxes:

____ ADD collateral ____ DELETE collateral ____ RESTATE covered collateral

____ ASSIGN collateral

Indicate collateral:

9. NAME OF SECURED PARTY OF RECORD AUTHORIZING THIS AMENDMENT - provide only one name (9a or 9b) (name of Assignor, if this is an Assignment)

If this is an Amendment authorized by a DEBTOR, check here ____ and provide name of authorizing Debtor

9a. ORGANIZATION'S NAME
________________________________
OR

9b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME
________________________________ ____________________________

ADDITIONAL NAME(S)/INITIAL(S) SUFFIX
________________________________ _____________

10. OPTIONAL FILER REFERENCE DATA

________________________________

[UCC FINANCING STATEMENT AMENDMENT (Form UCC3)]

UCC FINANCING STATEMENT AMENDMENT ADDENDUM

FOLLOW INSTRUCTIONS

11. INITIAL FINANCING STATEMENT FILE NUMBER (same as item 1a on Amendment form)

________________________________

12. NAME OF PARTY AUTHORIZING THIS AMENDMENT (same as item 9 on Amendment form)

12a. ORGANIZATION'S NAME
________________________________
OR

12b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME
________________________________ ____________________________

ADDITIONAL NAME(S)/INITIAL(S) SUFFIX
________________________________ _____________

THE ABOVE SPACE IS FOR

FILING OFFICE USE ONLY

13. Name of DEBTOR on related financing statement (Name of a current Debtor of record required for indexing purposes only in some filing offices - see Instruction for item 13 - insert only one Debtor name (13a or 13b) (use, exact, full name; do not omit, modify, or abbreviate any word in the Debtor's name)

13a. ORGANIZATION'S NAME
________________________________
OR

13b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME
________________________________ ____________________________

ADDITIONAL NAME(S)/INITIAL(S) SUFFIX
________________________________ _____________

14. ADDITIONAL SPACE FOR ITEM 8 (Collateral)

________________________________

15. This FINANCING STATEMENT AMENDMENT: ____ covers timber to be cut

____ covers as-extracted collateral ____ is filed as a fixture filing

16. Name and address of a RECORD OWNER of real estate described in item 17 (if Debtor does not have a record interest):

________________________________

17. Description of real estate

________________________________

18. MISCELLANEOUS:

________________________________

[UCC FINANCING STATEMENT AMENDMENT ADDENDUM (Form UCC3Ad)]

Source

    Laws 2011, LB90, ยง 20.
    Note: This section was repealed by Laws 2011, LB90, section 33. Laws 2011, LB90, section 20, added a new section 9-521.

Annotations

COMMENT

1. Source. New.

2. "Safe Harbor" Written Forms. Although section 9-520 limits the bases upon which the filing office can refuse to accept records, this section provides sample written forms that must be accepted in every filing office in the country, as long as the filing office's rules permit it to accept written communications. By completing one of the forms in this section, a secured party can be certain that the filing office is obligated to accept it.

The forms in this section are based upon national financing statement forms that were in use under former article 9. Those forms were developed over an extended period and reflect the comments and suggestions of filing officers, secured parties and their counsel, and service companies. The formatting of those forms and of the ones in this section has been designed to reduce error by both filers and filing offices.

A filing office that accepts written communications may not reject, on grounds of form or format, a filing using these forms. Although filers are not required to use the forms, they are encouraged and can be expected to do so, inasmuch as the forms are well designed and avoid the risk of rejection on the basis of form or format. As their use expands, the forms will rapidly become familiar to both filers and filing office personnel. Filing offices may and should encourage the use of these forms by declaring them to be the "standard" (but not exclusive) forms for each jurisdiction, albeit without in any way suggesting that alternative forms are unacceptable.

The multi-purpose form in subsection (b) covers changes with respect to the debtor, the secured party, the collateral, and the status of the financing statement (termination and continuation). A single form may be used for several different types of amendments at once (e.g., both to change a debtor's name and continue the effectiveness of the financing statement).