Ed Murray
Wyoming Secretary of State
2020 Carey Avenue, Suite 700
Cheyenne, WY 82002-0020
Ph. 307.777.7311
Fax 307.777.5339
Email: [email protected]
For Office Use Only
Effective Financing Statement (EFS) Amendment
1. Contact and Send Acknowledgment To:
a. Name and Phone of Contact at Filer (optional)
b. PAD Account # to be Charged
c. Send Acknowledgement To: (Name and Address)
d. Email Contact at Filer (optional)
2. Original Financing Statement Information:
a. Wyoming EFS No.
Date of Filing:
3. Amendment Types:
Continuation ($15; $30 if > 2 pages)
Continues the expiration date of the filing by 5
years. May only be filed within six (6) months
of the expiration of the lien. Must be signed by
both the debtor, item 4c, and secured party,
item 5c.
Termination ($5 if EFS filed prior to
7/1/2001; otherwise no fee)
The secured party no longer claims a
security interest. Must be signed by the
secured party in item 5c.
Add Secured Party (item 6)
Changed Secured Party (item 6)
Delete Secured Party (item 6)
($15; $30 if > 2 pages)
Must be signed by both the debtor, item 4c, and secured
party, item 5c. If an addition, item 6e must also be completed.
Assignment – Full or Partial
($15; $30 if > 2 pages)
Provide name of Assignee in item 6a or b, and
address of Assignee in 6c. Assignor to sign in 5c
and Assignee in 6e. The secured party’s rights
to the property described in item 7 has been
assigned to the assignee listed in item 6.
Add Debtor (item 6)
Changed Debtor (item 6)
Delete Debtor (item 6)
($15; $30 if > 2 pages)
Must be signed by both the debtor, item 4c, and secured
party, item 5c. If an addition, item 6e must also be
completed.
Partial Release
($15; $30 if > 2 pages)
The secured party releases the collateral
described in item 7 below. Must be signed
by the Secured Party in item 5c.
Add Collateral (item 7)
Changed Collateral (item 7)
Delete Collateral (item 7)
($15; $30 if > 2 pages)
Must be signed by both the debtor, item 4c, and secured
party, item 5c. If an addition, item 6e must also be
completed.
4. First Original Debtor’s Exact Full “Legal” Name (you must indicate additional original debtors on the addendum form):
a. Organization Name
Or
b. Individual’s Last Name
First Name
Middle Name
Suffix
Middle Name
Suffix
c. Debtor’s Signature, Authorization, or Authentication
5. Original Secured Party’s or Assignee’s Exact Full “Legal” Name:
a. Organization Name
Or
b. Individual’s Last Name
First Name
c. Secured Party’s Signature, Authorization, or Authentication
Check if Assignee
6. Changed or Added Information (only one (1) name (6a or 6b):
a. Organization Name
Or
b. Individual’s Last Name
First Name
Middle Name
Suffix
c. Mailing Address
City
State
d. SSN or EIN (for debtor only)
e. Debtor’s/Secured Party’s Signature, Authorization, or Authentication
Postal Code
7. Updated Farm Product Information:
Indicate
Add/Change/Delete
Farm Product
6. Check Applicable Option:
7. Pay Proceeds to Debtor and Secured Party
unless otherwise checked:
EFS_Amendment_Form – Revised February 2016
Code
Year
Proceeds Covered
Secured Party Only
Quantity
County
Code
Description/Location in County
Products Covered
Debtor Only
Attachments
Instructions for Completing EFS Amendment Form General Instructions:  Please type this form.  Verify all information you enter for accuracy and correct spelling. Any error may result in your lien becoming ineffective.  Acknowledgement Letter: A system derived acknowledgement letter will be returned to you to retain with your records. Please verify the information appearing on the acknowledgement letter for accuracy and correct spelling. If you discover a problem, please contact our office immediately at (307) 777.7311.  Fees: See each amendment type for the specific fee. Section 2: Original Financing Statement Information Wyoming EFS No. and Date of Filing: You must list the initial filing number and the date the original lien was recorded with our Office. Be sure to check the number for accuracy. Please do not provide a filing number assigned to an amendment. Only one (1) filing number per form is permitted. Section 3: Amendment Types Check the appropriate box for the amendment you are performing. Section 4: First Original Debtor’s Exact Full “Legal” Name: You must list all original debtors when filing an EFS Amendment. To do so, you will list the first debtor in Section 4 and subsequent debtors in Sections 9 and 10 on the Amendment Addendum form. Section 5: Original Secured Party’s or Assignee’s Exact Full “Legal” Name: You must provide the original secured party/assignee information. EFS_Amendment_Instructions – Revised February 2016 Section 6: Changed or Added Information These fields are to be used when adding, changing, or deleting a debtor’s or secured party’s information. You can list either an individual name or an organization name, but not both. SSN/EIN (6d): The SSN is required for an individual debtor and the debtor’s internal revenue service (IRS) employer identification number (EIN) is required for each business, corporation and trade name. Debtor Signature (4c and 6e): A new debtor being added must sign, authorize, or authenticate in item 6e. In all other cases, the current debtor must sign, authorize, or authenticate in item 4c. Please review the amendment types on the form to determine when the debtor’s signature, authorization, or authentication is required for each amendment. Secured Party Signature (5c and 6e): A new secured party or assignee being added must sign, authorize, or authenticate in item 6e. In all other cases, the current secured party must sign, authorize, or authenticate in item 5c. Please review the amendment types on the form to determine when the debtor’s signature, authorization, or authentication is required for each amendment. Section 7: Updated Farm Product Information These fields are used when adding, changing, or deleting a farm product. Please indicate what the intent is. NOTE: you must list the specific farm products. Listing “all livestock and crops” will not suffice. Ed Murray
Wyoming Secretary of State
2020 Carey Avenue, Suite 700
Cheyenne, WY 82002-0020
Ph. 307.777.7311
Fax 307.777.5339
Email: [email protected]
For Office Use Only
EFS Amendment Addendum Form
This addendum must accompany the EFS amendment form and be filed by the Secured Party in compliance with the Federal Act.
8. Original Financing Statement Information:
a. Wyoming EFS No.
Date of Filing:
9. Second Original Debtor’s Exact Full “Legal” Name (9a or 9b):
a. Organization Name
Or
b. Individual’s Last Name
First Name
Middle Name
Suffix
Middle Name
Suffix
Middle Name
Suffix
c. Debtor’s Signature, Authorization, or Authentication
10. Third Original Debtor’s Exact Full “Legal” Name (10a or 10b):
a. Organization Name
Or
b. Individual’s Last Name
First Name
c. Debtor’s Signature, Authorization, or Authentication
11. Additional Changed or Added Information (only one (1) name (9a or 9b):
a. Organization Name
Or
b. Individual’s Last Name
First Name
c. Mailing Address
City
State
d. SSN or EIN (for debtor only)
e. Debtor’s/Secured Party’s Signature, Authorization, or Authentication
Postal Code
12. Additional Changed or Added Information (only one (1) name (10a or 10b):
a. Organization Name
b. Individual’s Last Name
First Name
Middle Name
Suffix
c. Mailing Address
City
State
d. SSN or EIN (for debtor only)
e. Debtor’s/Secured Party’s Signature, Authorization, or Authentication
Postal Code
13. Updated Farm Products Information:
Indicate
Add/Change/Delete
Farm Product
EFS_Amendment_Addendum – Revised February 2016
Code
Year
Quantity
County
Code
Description/Location in County
Ed Murray
Wyoming Secretary of State
Business Division
2020 Carey Avenue, Suite 700
Cheyenne, WY 82002-0020
Ph. 307.777.7311
Email: [email protected]
Farm Product Codes List
When completing an Effective Financing Statement (EFS) form, farm product
codes must be used in the “Code” column of the form. For example, if the farm
product is beef cattle/calves use “5001” in the “code” column of the form.
Code
1001
1002
1003
1005
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2100
2200
2300
2400
2500
2600
2700
2800
2901
2902
2903
2904
3000
3101
Description
Buckwheat
Spring Wheat
Winter Wheat
Straw
Barley
Rye - includes triticale
Oats
Sorghum Grain
Flaxseed
Safflower
Field Corn
Alfalfa
Clover
Millet
Milo
Durum
Sorghum Sudan Grass
Malt Barley
Hay
Ensilage
Potatoes
Sugar Beets
Dry Beans
Sweet Corn
Onions
Mint
Popcorn
Sunflower Seeds
Canola Seed
Cotton Seed
Soybeans
Grass for Seed
Code
3102
3103
3104
3105
3106
3107
3108
3109
3201
3202
3203
3204
3205
3206
3207
3208
3209
3210
3211
3212
3213
3214
3215
3216
3217
3301
3302
3401
3402
3501
3502
3503
Description
Alfalfa for Seed
Mustard
Vetch/Fescue
Herbs
Carrot Seed
Onion Seed
Pea Seed
Clover Seed
Green Peas
Tomatoes
Lettuce
Cucumbers
Broccoli
Cauliflower
Lima Beans
Green Beans
Hominy
Carrots
Turnips
Asparagus
Spinach & Collards
Pumpkin & Squash
Watermelon
Muskmelon
Cantaloupe
Apples
Plums
Strawberries
Raspberries
Sod
Nursery Stock (Trees, Shrubs)
Flowers, Potted Plants
1
Ed Murray
Wyoming Secretary of State
Business Division
2020 Carey Avenue, Suite 700
Cheyenne, WY 82002-0020
Ph. 307.777.7311
Email: [email protected]
Code
3600
5001
5002
5003
5101
5102
5103
5104
5105
5106
5200
5301
5302
5303
5401
5402
5403
5501
5502
5601
5602
5603
5604
5605
Description
Mushrooms
Beef Cattle, Calves
Buffalo
Bison
Sheep and Lambs
Wool
Goats
Llamas
Alpacas
Mohair
Hogs
Dairy Cattle
Milk
Cream
Horses
Mules
Donkeys, Burros
Chickens
Eggs
Turkeys
Ducks
Geese
Game Bird, Ostrich
Ostrich
Code
5701
5702
5703
5704
5750
5751
5801
5802
5803
5804
5901
6001
6002
6100
6201
6202
7001
7002
7003
7004
7005
7008
7009
7010
Description
Mink/Pelts
Rabbits
Fox & Pelts
Lynx, Bobcat, Pelts
Dogs
Cats
Bees, Hives
Honey
Beeswax
Bee Pollen
Fish
Deer
Elk
Worms
Cattle Semen
Horse Semen
Sugar Beet Top Pasture
Corn Stubble
Alfalfa Pasture
Oats Pasture
Barley Stubble
Commercial Feed
Radish Seed
Sainfoin
Revised 12/2015
2
Ed Murray
Wyoming Secretary of State
Business Division
2020 Carey Avenue, Suite 700
Cheyenne, WY 82002-0020
Ph. 307.777.7311
Email: [email protected]
County Codes
When completing an Effective Financing
Statement (EFS) form, Wyoming's
county codes must be used under the
"county code" section.
For example, if beef cattle/calves are
produced in Park County, then the
"county code" of "11" must appear in the
"county code" column of the form. See
the State of Wyoming Effective
Financing Statement (EFS) forms.
County
Name
Albany
Big Horn
Campbell
Carbon
Converse
Crook
Fremont
Goshen
Hot Springs
Johnson
Laramie
Lincoln
Natrona
Niobrara
Park
Platte
Sheridan
Sublette
Sweetwater
Teton
Uinta
Washakie
Weston
County
Code
05
09
17
06
13
18
10
07
15
16
02
12
01
14
11
08
03
23
04
22
19
20
21