Release of U.C.C. Financing Statement
This Release of Financing Statement is presented for filing under the Uniform Commercial Code as adopted in ________________________ [name of your state].
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Name of Borrower: __________________________________________
Address of Borrower: _________________________________________
Name of Lender/Secured party: ________________________________
Address of Lender/Secured party: ________________________________
The term Borrower refers to one or more borrowers. The term Lender refers to any person who legally holds this note, including a buyer in due course.
The property listed as collateral in the security agreement is as follows [identify or describe]:
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File number of Financing Statement: ___________
Date filed: ________________________________
Address of filing office: _________________________________________

Borrower's signature: ________________________________
Print name: _______________________________________
Date: ______________________________
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(For Use of the Filing Officer)
Date of filing: ______________________	Time of filing: ___________________
File number and address of filing office: ________________________________