Free ra9_ucc_4.p65 - Idaho

Mail to: Secretary of State, UCC Division, 700 W Jefferson, Box Box 83720, Boise ID 83720-0080 450 N 4th, PO PO 83720, Boise ID 83720-0080 Telephone: 208-334-3191 Fax: 208-334-2847

Instructions 1. Enter your Secretary of State customer number (if known) in the requesting party section. If the fee is to be charged to your pre-paid account, the customer number must be entered. 2. Enter the name of the Debtor (or Producer) exactly as you want it to be searched. Enter only one name. 3. In the Address block, you may enter either a complete address or a city name to limit the scope of the search. You may enter "Any address" if you want all filings against the Debtor name without regard to location. Debtor, Producer or Purchaser of Agricultural Products on whom information is requested.
Organization or Indiv. Last Name First Name Middle Name Suffix

This block for Filing Office use only.

STATE OF IDAHO - REQUEST FOR INFORMATION OR COPIES - UCC-4

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Name and address of requesting party

SSN/TIN (if known)

Customer account number
Address

Contact Person
City State

ID

Zip

Phone #

INFORMATION REQUEST Filing officer: Please furnish a certificate showing any presently effective notices of the types indicated below relating to the above named Debtor or Producer. (Check box(es) for type(s) of notices to be reported on certificate. Check one or more. If no boxes are checked, it will be assumed you want all types.) UCC financing statements (other than farm products) (*)See note below. Government Liens (IRS, indigent, employment, state tax, etc.) Effective financing statements (EFS) pertaining to farm products Liens in crops, for seed or farm labor Liens on agricultural products, after sale/delivery to purchasers

COPY REQUEST

Filing officer: If this box is checked, please provide a copy of the documents reported on the certificate.

Filing officer: If this box is checked, please provide a copy of first page only of the documents reported on the certificate. (This option is not available for faxed reports).

Include all active filings. Checking this box will cause your search results to include lapsed filings within one year of lapse date.

Signature of Requesting Party: 1. If only one notice type is checked in the information request, enter $6.00. If more than one is checked, enter $10.00. If Agricultural Products information request, enter $5.00. (*) NOTE: If you are requesting basic search $ only, the fee is $12.00 regardless of whether it is info. only, info. with copies or expedited service requested. If copies are requested, enter $6.00. If the request is not typed, enter $4.00. If expedited service is requested, enter $10.00. Indicate how you want the search handled by checking the appropriate box. $
Mail to requesting party Call when ready _________________ Courier company & account # __________________ Fax # _________________ (50¢ per page fax fee invoiced separately)

2. 3. 4.

$ $

Pay this amount (If charging to your pre-paid account, please be sure you have filled in your customer account number.)
Rev. 07/2001

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0.00