Vous êtes sur la page 1sur 3

vee APPROVAL SHEET

** KEEP WITH DOCUMENT **


111111111111111'
__ DOA - Original Financing Statement 1000362002305342
with assignment $25.00
__ DOTU - Original Financing Statement
Transmitting Utility $25.00
UMA - Amendment $25.00
UMDA - Amendment - Debtor Added $25.00
__ UMDC - Amendment-
Debtor Name Change $25.00
UMDD - Amendment - Debtor Deleted $25.00
__ UMSA - Amendment-
Secured Party Added
UMSC - Amendment -
Secured Party Name Change
UMSD - Amendment -
Secured Party Deleted
C - mendment - Continuation
-->r-+-UMT f\mendment - Termination
- Amendment - Assignment
-4-_ UMZP - Amendment -
Partial Assignment
UMCS - Amendment -
Correction Statement
__ UOMH - Manufactured Home -
$25.00
$25.00
$25.00
$25.00
$25.00
$25.00
$25.00
$25.00
Original Financing Statement $25.00
__ UOPF - Public Finance-
Original Financing Statement $25.00
__ Documents Nine (9) Pages or More $75.00
__ Certified Copies /I;
__ Plain Copies ' 'jz:
TOTAL FEES:

rI"--..6.. '.U.4r.A.
RECORDED ON 09/23/2011 AT 04:11 PM
IN THE FINANCING RECORDS OF THE MD ST
DEPARTMENT OF ASSESSMENTS AND TAXATION'
WO a 0003846966 ACK a 1000362002305342
ORIGINAL FILE NUMBER: 0000000181425776
PAGES: 0003
D OTHER CHANGES:
Code ____ _
Attention:
-----------------------------------
Mail to Address:
NO FEE TRANSACTION TYPES
/ IRS TECHNICA .
TREASURY DIVISION
INTERNAL REVENUE ACT TRUST
1500 PENNSYLVA SERVICE
__ VRC - Copies
__ VNCP- Void-Non-Payment
__ VCC - Cancellation
__ VCR - Reinstatement
__ VCO - Departmental Action
VCREF - Refund Recordation Tax
VCIS - Incorrect ID Number
XOVRV - VCC Overrides
WASHINGTON DC ;J:
2
:VENUE, NORTH WEST
__ UMFC - Filing Office Correction Statement
CashD
Number of Chec
Comments(s):
UCC FINANCING STATEMENT AMENDMENT
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
A. NAME & PHONE OF CONTACT AT FILER
Circuit Court for MONTGOMERY COUNTY (240) 777-9400
B. SEND ACKNOWLEDGMENT TO: (Name and Address)
f;,s Technical Support Division
C/o Treasury UCC Contract Trust
Internal Revenue Service
1500 Pennsylvania Avenue, North West
Washington, District of Columbia 20220

1a. INITIAL FINANCING STATEMENT FILE #
0000000181425776
2. TERMINATION: Effectiveness of the Financing Statement identified above is terminated with respect to security interest(s) of the Secured Party auu'v" .... o .
3. CONTINUATION: Effectiveness of the Financing Statement identified above with respect to security interest(s) of the Secured Party authorizing this Continuation Statement is
continued for the additional period provided by applicable law.
4. ASSIGNMENT (full or partial): Give name of assignee in item 7a or 7b and address of aSSignee in item 7c; and also give name of assignor in item 9.
5. AMENDMENT (PARTY INFORMATION): This Amendment affects Secured Party of record. Check only 2M of these two boxes.
Also check 2M of the following three boxes BIll! provide appropriate information in items 6 andlor 7.
CHANGE name andlor address: Please refertothe detailed instructions
lnre ardstochan in thename/addressofa a
DELETE name: Give record name
to be deleted in item 6a or 6b.
ADD name: Complete item 7a or 7b. and also item 7 c;
alsocom leteitems7e-7 if a licable.
6. CURRENT RECORD INFORMATION:
5a. ORGANIZATION'S NAME
THE UNITED STATES OF AMERICA
OR 5b. INDIVIDUAL'S LAST NAME
7, CHANGED (NEW) OR ADDED INFORMATION:
7a. ORGANIZATION'S NAME
FIRST NAME
OR
[- SEAL OF THE OFFICE OF SECRETARY OF STATE-]
7b. INDIVIDUAL'S LAST NAME FIRST NAME
7c. MAILING ADDRESS CITY
50 MARYLAND AVE ROCKVILLE
7d. SEE INSTRUCTIONS ,rDD'L INFO RE 17e. TYPE OF ORGANIZATION 7f. JURISDICTION OF ORGANIZATION
ORGANIZATION
14,300,000,000,000,' DEBTOR I a Fiduciary The United States of America
8. AMENDMENT (COLLATERAL CHANGE): check only 2M box.
Describe collateral 0 deleted or 0 added, or give entire o restated collateral description, or describe collateral 0 assigned.
federal identification number: PAYER
RECIPIANT identification number: Social Security Number
Account number: 0000000181425776 Seal No.
Original Issue Discount for *.
$14,300,000,000,000.-
[Federal Income tax withheld - $14,300,000,000,000.-]
Description: Public Trust
Original Issue discount on U.S. Treasury obligations*
MIDDLE NAME
MIDDLE NAME
STATE rOSTAL CODE
MD 20850
7g. ORGANIZATIONAL 10 #, if any
AG 59880464 A
SUFFIX
-ent
SUFFIX
COUNTRY
u.s.a.
o NONE
9. NAME OF SECURED PARTY OF RECORD AUTHORIZING THIS AMENDMENT (name of assignor, if this is an Assignment). Ilthis is an Amendment authorized by a Debtor which
adds collateral or adds the authorizing Debtor, or if this is a Termination authorized by a Debtor, check here and enter name of DEBTOR authorizing this Amendment.
9a. ORGANIZATION'S NAME
THE UNITED STATES OF AMERICA
OR 9b. INDIVIDUAL'S LAST NAME MIDDLENI'.ME SUFFIX FIRST NAME
-ent
10.0PTIONAL FILER REFERENCE DI'.TA
\1Y(4')o'jtI"-' HSI.tt.. CO/p) -: A ,\',(.. tOYYV\ Ce.\- No P14'Z.\ tt
FILING OFFICE COpy - UCC FINANCING STATEMENT AMENDMENT (FORM UCC3) (REV. 05/22/02)
UCC FINANCING STATEMENT AMENDMENT ADDENDUM
FOLLOW INSTRUCTIONS (front and back) CAREFULLY
11. INITIAL FINANCING STATEMENT FILE # (same as item 1a on Amendment form)
0000000181425776
12. NAME OF PARTY AUTHORIZING THIS AMENDMENT (same as item 9 on Amendmentform)
12a. ORGANIZATION'S NAME
OR
THE UNITED STATES OF AMERICA (Obligor)
12b. INDIVIDUAL'S LAST NAME IFIRST NAME
13. Use this space for additional information
PAYER = Obligor
RECIPIANT = Owner
RECIPIANT = Beneficiary
Re-Public Trust = Obligation
IMIDDLE NAME,SUFFIX
THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY
FILING OFFICE COPY - NATIONAL UCC FINANCING STATEMENT AMENDMENT ADDENDUM (FORM UCC3Ad) (REV. 07/29/98)