UCC1 House Lien Template Example

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Instructions for UCC Financing Statement (Form UCC1)

Please type or print this form. Be sure it is completely legible. Forms with handwritten entries may be rejected. Read and follow all Instructions.
Fill in form very carefully; mistakes may have important legal consequences. If you have questions, consult your attorney. The filing office cannot give
legal advice.
Unless specifically required by applicable state law, DO NOT include social security numbers, driver’s license numbers, financial account numbers or
other non-public personally identifiable information anywhere on the form.
Form instructions are intended for paper forms. Electronic UCC filing parameters and instructions may differ from the below instructions.
Send completed form and any attachments to the filing office, with the required fee.

ITEM INSTRUCTIONS

A and B. To assist filing offices that might wish to communicate with filer, filer may provide information in item A and item B. These items are optional.
C. Complete item C if filer desires an acknowledgment sent to them.

1. Debtor’s name. Carefully review applicable statutory guidance about providing the debtor’s name. Enter only one Debtor name in item 1 -- either an
organization’s name (1a) or an individual’s name (1b). If any part of the Individual Debtor’s name will not fit in line 1b, check the box in item 1, leave
all of item 1 blank, check the box in item 9 of the Financing Statement Addendum (Form UCC1Ad) and enter the Individual Debtor name in item 10
of the Financing Statement Addendum (Form UCC1Ad). Enter Debtor’s correct name. Do not abbreviate words that are not already abbreviated in
the Debtor’s name. If a portion of the Debtor’s name consists of only an initial or an abbreviation rather than a full word, enter only the abbreviation
or the initial. If the collateral is held in a trust and the Debtor name is the name of the trust, enter trust name in the Organization’s Name box in item
1a.

1a. Organization Debtor Name. “Organization Name” means the name of an entity that is not a natural person. A sole proprietorship is not an organiza-
tion, even if the individual proprietor does business under a trade name. If Debtor is a registered organization (e.g., corporation, limited partnership,
limited liability company), it is advisable to examine Debtor’s current filed public organic records to determine Debtor’s correct name. Trade name
is insufficient. If a corporate ending (e.g., corporation, limited partnership, limited liability company) is part of the Debtor’s name, it must be included.
Do not use words that are not part of the Debtor’s name.

1b. Individual Debtor Name. “Individual Name” means the name of a natural person; this includes the name of an individual doing business as a sole
proprietorship, whether or not operating under a trade name. The term includes the name of a decedent where collateral is being administered by a
personal representative of the decedent. The term does not include the name of an entity, even if it contains, as part of the entity’s name, the name of
an individual. Prefixes (e.g., Mr., Mrs., Ms.) and titles (e.g., M.D.) are generally not part of an individual name. Indications of lineage (e.g., Jr., Sr., III)
generally are not part of the individual’s name, but may be entered in the Suffix box. Enter individual Debtor’s surname (family name) in Individual’s
Surname box, first personal name in First Personal Name box, and all additional names in Additional Name(s)/Initial(s) box.
If a Debtor’s name consists of only a single word, enter that word in Individual’s Surname box and leave other boxes blank.

For both organization and individual Debtors. Do not use Debtor’s trade name, DBA, AKA, FKA, division name, etc. in place of or combined with
Debtor’s correct name; filer may add such other names as additional Debtors if desired (but this is neither required nor recommended).

For both organization and individual Debtors. Name variations may be optionally provided as additional debtors. Do not combine multiple names in
one section. Provide each name variation and address as described in the instructions for item 2 below.

1c. Enter a mailing address for the Debtor named in item 1a or 1b.

2. Additional Debtor’s name. If an additional Debtor is included, complete item 2, determined and formatted per Instruction 1. For additional Debtors,
attach either Addendum (Form UCC1Ad) or Additional Party (Form UCC1AP) and follow Instruction 1 for determining and formatting additional names.

3. Secured Party’s name. Enter name and mailing address for Secured Party or full Assignee who will be the Secured Party of record. For additional
Secured Parties, attach either Addendum (Form UCC1Ad) or Additional Party (Form UCC1AP). Optional: Attach Addendum (Form UCC1Ad) giving
Assignor Secured Party’s name and mailing address in item 11.

4. Collateral. Use item 4 to indicate the collateral covered by this financing statement. If space in item 4 is insufficient, continue the collateral description
in item 12 of the Addendum (Form UCC1Ad) or attach additional page(s) and incorporate by reference in item 12 (e.g., See Exhibit A).

Note: If this financing statement covers timber to be cut, covers as-extracted collateral, and/or is filed as a fixture filing, attach Addendum (Form UCC1Ad)
and complete the required information in items 13, 14, 15, and 16. Consult applicable state UCC law for filing location.

5. If collateral is held in a trust or being administered by a decedent’s personal representative, check the appropriate box in item 5. If more than one
Debtor has an interest in the described collateral and the check box does not apply to the interest of all Debtors, the filer should consider filing a
separate Financing Statement (Form UCC1) for each Debtor.

6a. If this financing statement relates to a Public-Finance Transaction, Manufactured-Home Transaction, or a Debtor is a Transmitting Utility, check the
appropriate box in item 6a. If a Debtor is a Transmitting Utility and the initial financing statement is filed in connection with a Public-Finance Transaction
or Manufactured-Home Transaction, check only that a Debtor is a Transmitting Utility.

6b. If this is an Agricultural Lien (as defined in applicable state’s enactment of the Uniform Commercial Code) or if this is not a UCC security interest filing
(e.g., a tax lien, judgment lien, etc.), check the appropriate box in item 6b and attach any other items required under applicable law.

7. Alternative Designation. If filer desires (at filer’s option) to use the designations lessee and lessor, consignee and consignor, seller and buyer (such
as in the case of the sale of a payment intangible, promissory note, account or chattel paper), bailee and bailor, or licensee and licensor instead of
Debtor and Secured Party, check the appropriate box in item 7.

8. Optional Filer Reference Data. This item is optional and is for filer’s use only to provide reference information the filer may find useful.
UCC FINANCING STATEMENT
FOLLOW INSTRUCTIONS

A. NAME & PHONE OF CONTACT AT SUBMITTER (optional)


John-Lee: Moore
B. E-MAIL CONTACT AT SUBMITTER (optional)

C. SEND ACKNOWLEDGMENT TO: (Name and Address)

John-Lee: Moore
c/o 5801 Winding Way
Humble, Texas [77338-2367]
Print Reset
SEE BELOW FOR SECURED PARTY CONTACT INFORMATION
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 part of the Debtor’s name); if any part of the Individual Debtor’s name will
not fit in line 1b, leave all of item 1 blank, check here and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad)

1a. ORGANIZATION’S NAME


LOCKE MORTGAGE SERVICES t
OR
1b. INDIVIDUAL’S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S)/INITIAL(S) SUFFIX

1c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY

1 W. WILSON ST. MADISON WI 53703 USA


2. DEBTOR’S NAME: Provide only one Debtor name (2a or 2b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor’s name); if any part of the Individual Debtor’s name will
not fit in line 2b, leave all of item 2 blank, check here and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad)

2a. ORGANIZATION’S NAME

OR
2b. INDIVIDUAL’S SURNAME FIRST PERSONAL NAME ADDITIONAL NAME(S)/INITIAL(S) 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

Moore John Lee


3c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY

5801 Winding Way Humble TX 77338-2367 usa


4. COLLATERAL: This financing statement covers the following collateral:

This is the Collateral by Trustee/Secured Party on behalf of the Trust/Estate: JOHN LEE MOORE
TRUST in the Commercial Chamber under the necessity to secure the right, title(s), interest, and
value therefore, in and of the Root of Title from inception. This Maritime Lien is under safe harbor
and sinking funds provisions through the prescription of Law necessity with Applicable Law,
Cardinal Orders, Ordinal Orders, and Commercial Standards. All property belonging to Debtor
belongs to Secured Party.
5801 Winding Way., Humble, TX 77338-2367. 4BD 2BA, 2,842 SQFT, APN# 2701125000, Lot
Size:
3,685 SQFT

5. Check only if applicable and check only one box: Collateral is held in a Trust (see UCC1Ad, item 17 and Instructions) being administered by a Decedent’s Personal Representative
6a. Check only if applicable and check only one box: 6b. Check only if applicable and check only one box:
Public-Finance Transaction Manufactured-Home Transaction A Debtor is a Transmitting Utility 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:


Equity Title Holder, Beneficiary/Settlor/Subrogee
FILING OFFICE COPY — UCC FINANCING STATEMENT (Form UCC1) (Rev. 07/01/23)

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