UCC-3 Termination Statement Template
Important Note: This template helps organize the required information, but an actual filing may need to be submitted on the official UCC-3 form accepted by the filing office.
Date: [Date]
Internal Reference Number: [Reference Number, if applicable]
Original Financing Statement File Number: [File Number]
Original Filing Date: [Date]
Filing Office: [State / Jurisdiction / Office Name]
2. Termination Statement
The effectiveness of the financing statement identified above is terminated with respect to the security interest or interests of the secured party authorizing this Termination Statement.
Debtor Name: [Full Legal Name of Debtor]
Debtor Address: [Address]
City, State, ZIP Code: [City, State, ZIP Code]
Additional debtor information, if applicable:
[Insert additional debtor details]
4. Secured Party of Record Authorizing Termination
Secured Party Name: [Full Legal Name of Secured Party]
Secured Party Address: [Address]
City, State, ZIP Code: [City, State, ZIP Code]
Loan, Account, or Internal Reference Number: [Reference Number, if applicable]
Description of obligation or filing being released, if needed:
[Insert short description]
6. Collateral Reference
This termination applies to:
☐ all collateral covered by the identified financing statement
☐ only the following collateral or security interest:
[Describe collateral, if partial reference is needed]
7. Authorization
The undersigned secured party of record authorizes the filing of this Termination Statement relating to the financing statement identified above.
Contact Name: [Full Name]
Company or Firm: [Company / Law Firm / Filing Service, if applicable]
Phone Number: [Phone Number]
Email Address: [Email Address]
9. Signature
Authorized Signature: __________________________
Name: [Full Name]
Title: [Title]
For Secured Party: [Secured Party Name]
Date: [Date]
10. Additional Notes
Additional filing notes or instructions:
[Insert notes]
This Termination Statement is intended only to relate to the financing statement identified above. Any filing office cover sheet, fee, addendum, or jurisdiction-specific requirement should be completed separately.