STATE OF CALIFORNIA
UNIFORM COMMERCIAL CODE - FINANCING STATEMENT - FORM UCC-1 (REV. 1/90)
IMPORTANT - Read instructions on back before filling out form
wolcotts form ucc-1ca

STOCK # 82901
(price class 13C)

This FINANCING STATEMENT is presented for filing and will remain effective, with certain exceptions,
for five years from the date of filing, pursuant to Section 9403 of the California Uniform Commercial Code.

1. DEBTOR (LAST NAME FIRST—IF AN INDIVIDUAL)
1A. SOCIAL SECURITY OR FEDERAL TAX NO.

1B. MAILING ADDRESS
1C. CITY, STATE
1D. ZIP CODE

2. ADDITIONAL DEBTOR (IF ANY) (LAST NAME FIRST—IF AN INDIVIDUAL)
2A. SOCIAL SECURITY OR FEDERAL TAX NO.

2B. MAILING ADDRESS
2C. CITY, STATE
2D. ZIP CODE

3. DEBTOR’S TRADE NAMES OR STYLES (IF ANY)
1A. FEDERAL TAX NO.

4. SECURED PARTY
NAME
MAILING ADDRESS
CITY STATE ZIP CODE
4A. SOCIAL SECURITY NO. FEDERAL TAX NO.
OR BANK TRANSIT AND A. B. A. NO.

5. ASSIGNEE OF SECURED PARTY (IF ANY)
NAME
MAILING ADDRESS
CITY STATE ZIP CODE
5A. SOCIAL SECURITY NO. FEDERAL TAX NO.
OR BANK TRANSIT AND A. B. A. NO.

6. This FINANCING STATEMENT covers the following types of items of property (include description of real property on which
located and owner of record when required by instruction 4).

7. CHECK
IF APPLICABLE
7A. PRODUCTS OF COLLATERAL
ARE ALSO COVERED
7B. DEBTOR(S) SIGNATURE NOT REQUIRED IN ACCORDANCE WITH
INSTRUCTION 5(A) ITEM:

(1)
(2)
(3)
(4)

X

8. CHECK
IF APPLICABLE
DEBTOR IS A “TRANSMITTING UTILITY” IN ACCORDANCE WITH UCC § 9105 (1) (n)

X

9. DATE:
SIGNATURE(S) OF DEBTOR(S)
TYPE OR PRINT NAME(S) OF DEBTOR(S)
SIGNATURE(S) OF DEBTOR(S)
TYPE OR PRINT NAME(S) OF SECURED PARTY(IES)

10. THIS SPACE FOR USE OF FILING OFFICER
(DATE, TIME, FILE NUMBER
AND FILING OFFICER)

11. Return copy to:
NAME
ADDRESS
CITY
STATE
ZIP CODE

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(1) filing officer copy

FORM UCC-1
Approved by the Secretary of State