Financing statement form



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Date12.05.2016
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Chippewa Cree Tribe

FINANCING STATEMENT FORM

Filing Fee = $7.00

In the space below, type the name and address where you want
the Montana Secretary of State’s office to send your confirmation letter.
Return Name:      
Return Address:      

RESERVED FOR FILING OFFICE





Contact Name:      

Contact Phone Number:      


1. DEBTOR’S Exact Full “Legal” Name - Only one debtor name (1a or 1b)

or

1a. Organization’s Name

     


1b. Individual’s Last Name

     


First Name

     


Middle Name

     


Suffix

     


1c. Mailing Address

     


City

     


State

     


Postal Code

     


Country

     





1d. Reserved. Refer to Instructions.


1e. Type of Organization

     

1f. Jurisdiction of Organization


     
1g. Organizational ID#, if any

       None





2. Additional DEBTOR’S Exact Full “Legal” Name - Only one debtor name (2a or 2b)

or

2a. Organization’s Name

     


2b. Individual’s Last Name

     


First Name

     


Middle Name

     


Suffix

     


2c. Mailing Address

     


City

     


State

     


Postal Code

     


Country

     





2d. Reserved. Refer to Instructions.


2e. Type of Organization

     

2f. Jurisdiction of Organization


     
2g. Organizational ID#, if any

       None





3. SECURED PARTY’S Name – Only one secured party name (3a or 3b)

or

3a. Organization’s Name

     


3b. Individual’s Last Name

     


First Name

     


Middle Name

     


Suffix

     


3c. Mailing Address

     


City

     


State

     


Postal Code

     


Country

     






4. This UCC FINANCING STATEMENT covers the Collateral described below.

     


5. Optional Filer Reference      


Chippewa-Cree_UCC_Tribal_Form.doc Revised 3/7/2012



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