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UCC FINANCING STATEMENT

FOLLOW INSTRUCTIONS (front and back) CAREFULLY


A. NAME & PHONE OF CONTACT AT FILER [optional]
B. SEND ACKNOWLEDGEMENT TO:

(Name and Address)

John Henry Doe


c/o 1234 Creditor Street
Huntington Beach, California Republic
NON-DOMESTIC WITHOUT THE U.S.
ZZZ

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THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY

1. DEBTORS EXACT FULL LEGAL NAME insert only one debtor name (1a or 1b) do not abbreviate or combine names
1a. ORGANIZATIONS NAME
OR

PETER F DOE
1b. INDIVIDUALS LAST NAME

FIRST NAME

MIDDLE NAME

1c. MAILING ADDRESS

CITY

STATE

123 DEBTOR AVENUE

HUNTINGTON BEACH

ADDL INFO RE
ORGANIZATION
DEBTOR

1e. TYPE OF ORGANIZATION

1f. JURISDICTION OF ORGANIZATION

LEGAL ENTITY

USA

SUFFIX

POSTAL CODE

COUNTRY

92648

CA

USA

1g. ORGANIZATIONAL ID#, if any

***-**-1234

NONE

2. ADDITIONAL DEBTORS EXACT FULL LEGAL NAME insert only one debtor name (2a or 2b) do not abbreviate or combine names
2a. ORGANIZATIONS NAME
OR

JOHN H DOE
2b. INDIVIDUALS LAST NAME

FIRST NAME

MIDDLE NAME

2c. MAILING ADDRESS

CITY

STATE

1234 CREDITOR STREET

HUNTINGTON BEACH

ADDL INFO RE
ORGANIZATION
DEBTOR

2e. TYPE OF ORGANIZATION

2f. JURISDICTION OF ORGANIZATION

LEGAL ENTITY

USA

SUFFIX

POSTAL CODE

CA

COUNTRY

92648

USA

2g. ORGANIZATIONAL ID#, if any

***-**-6789

NONE

3. SECURED PARTYS NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR S/P) insert only one secured party name (3a or 3b)
3a. ORGANIZATIONS NAME
OR
3b. INDIVIDUALS LAST NAME

FIRST NAME

MIDDLE NAME

Doe

John

Henry

3c. MAILING ADDRESS

CITY

STATE

c/o 1234 Creditor Street, Huntington Beach, California

Non-domestic without the U.S.

SUFFIX

POSTAL CODE

COUNTRY

ZZZ

4. This FINANCING STATEMENT covers the following collateral:

THIS IS ACTUAL AND CONSTRUCTIVE NOTICE


All the Debtors' interest in all the Debtors' property, both registered and unregistered, is hereby Accepted as collateral for
securing contractual obligations in favor of the Secured Party. The value of the Secured Party's claim is One-hundred Billion
and 00/100 United States Dollars (USD $100,000,000,000.00). This is the entry of the DEBTORS into the Commercial Registry
and Public Notice of a commercial transaction. The Secured Party hereby secures all rights, interests and titles in said property.

VALUE: $100,000,000,000.00

5. ALTERNATIVE DESIGNATION [if applicable]:

LESSEE/LESSOR

CONSIGNEE/CONSIGNOR

This FINANCING STATEMENT is to be filed [for record] (or recorded) in


the REAL ESTATE RECORDS. Attach Addendum
[if applicable]
8. OPTIONAL FILER REFERENCE DATA
6.

BAILEE/BAILOR

SELLER/BUYER

7. Check to REQUEST SEARCH REPORT(S) on Debtor(s)


[ADDITIONAL FEE]
[optional]

COMMERCIAL SECURITY AGREEMENT #: SA-2010031501; SA-2010031502; and SA-2010031503


FILING OFFICE COPY NATIONAL UCC FINANCING STATEMENT (FORM UCC1) CALIFORNIA (REV. 01/01/08)

AG. LIEN

All Debtors

NON-UCC FILING
Debtor 1

Debtor 2

UCC FINANCING STATEMENT ADDENDUM


FOLLOW INSTRUCTIONS (front and back) CAREFULLY
9. NAME OF FIRST DEBTOR (1a or 1b) ON RELATED FINANCING STATEMENT
9a. ORGANIZATION NAME

PETER F DOE
OR

9b. INDIVIDUALS LAST NAME

FIRST NAME

MIDDLE NAME, SUFFIX

10. MISCELLANEOUS:

THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY

11. ADDITIONAL DEBTORS EXACT FULL LEGAL NAME insert only one name (11a or 11b) do not abbreviate or combine names
11a. ORGANIZATIONS NAME
OR

FRANK J DOE
11b. INDIVIDUALS LAST NAME

FIRST NAME

MIDDLE NAME

11c. MAILING ADDRESS

CITY

STATE

1234 DEBTOR CIRCLE

HUNTINGTON BEACH

ADDL INFO RE
ORGANIZATION
DEBTOR

12.

11e. TYPE OF ORGANIZATION

11f. JURISDICTION OF ORGANIZATION

LEGAL ENTITY

USA

ADDITIONAL SECURED PARTYS or

SUFFIX

POSTAL CODE

CA

92646

COUNTRY

USA

11g. ORGANIZATIONAL ID#, if any

***-**-2345

NONE

ASSIGNOR S/Ps NAME insert only one name (12a or 12b)

12a. ORGANIZATIONS NAME


OR
12b. INDIVIDUALS LAST NAME

12c. MAILING ADDRESS

13. This FINANCING STATEMENT covers


collateral, or is filed as a
14. Description of real estate:

timber to be cut or

as-extracted

FIRST NAME

MIDDLE NAME

SUFFIX

CITY

STATE

COUNTRY

POSTAL CODE

16. Additional collateral description:

fixture filing.

15. Name and address of a RECORD OWNER of above-described real estate


(if Debtor does not have a record interest):

17. Check only if applicable and check only one box.


Debtor is a

Trust or

Trustee acting with respect to property held in trust or

18. Check only if applicable and check only one box.


Debtor is a TRANSMITTING UTILITY
Filed in connection with a Manufactured-Home Transaction effective 30 years
Filed in connection with a Public-Finance Transaction effective 30 years

FILING OFFICE COPY NATIONAL UCC FINANCING STATEMENT ADDENDUM (FORM UCC1Ad) CALIFORNIA (REV. 01/01/08)

Decedents Estate

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