{"data":{"id":"us-hi/haw.-rev.-stat.-490-9-521","jurisdiction":"us-hi","citation":"Haw. Rev. Stat. § 490:9-521","heading":"Uniform form of written financing statement and amendment.","body":"(a) A filing office that accepts written records for filing may not refuse to accept a written initial financing statement in the following form, except for a reason set forth in section 490:9-516(b):\n\nUCC FINANCING STATEMENT\n\nFOLLOW INSTRUCTIONS\n\nA. NAME \u0026 PHONE OF CONTACT AT FILER (optional)\n\n____________________________________________\n\nB. E-MAIL CONTACT AT FILER (optional)\n\n____________________________________________\n\nC. SEND ACKNOWLEDGMENT TO: (Name and Address)\n\n____________________________________________\n\nTHE ABOVE SPACE IS FOR\n\nFILING OFFICE USE ONLY\n\n1. DEBTOR'S NAME - provide only one Debtor name (1a or 1b) (use exact, full name; do not omit, modify, or abbreviate any word in the Debtor's name)\n\n1a. ORGANIZATION'S NAME\n\n___________________________________________________________________________________________\n\nOR\n\n1b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME\n\n_________________________________ _________________________________________________\n\nADDITIONAL NAME(S)/INITIAL(S) THAT ARE PART OF THE NAME OF THIS DEBTOR SUFFIX\n\n_______________________________________________________________________ ________\n\n1c. MAILING ADDRESS\n\n___________________________________________________________________________________________\n\nCITY STATE POSTAL CODE COUNTRY\n\n____________________________ ______ _____________ ___________\n\n2. DEBTOR'S NAME - provide only one Debtor name (2a or 2b) (use exact, full name; do not omit, modify, or abbreviate any word in the Debtor's name)\n\n2a. ORGANIZATION'S NAME\n\n_____________________________________________________________________\n\nOR\n\n2b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME\n\n_________________________________ _____________________________\n\nADDITIONAL NAME(S)/INITIAL(S) THAT ARE PART OF THE NAME OF THIS DEBTOR SUFFIX\n\n_______________________________________________________________________ ________\n\n2c. MAILING ADDRESS\n\n___________________________________________________________________________________________\n\nCITY STATE POSTAL CODE COUNTRY\n\n____________________________ ______ _____________ ___________\n\n3. SECURED PARTY'S NAME (or NAME of ASSIGNEE of ASSIGNOR SECURED PARTY) - provide only one Secured Party name (3a or 3b)\n\n3a. ORGANIZATION'S NAME\n\n_____________________________________________________________________\n\nOR\n\n3b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME\n\n_________________________________ _____________________________\n\nADDITIONAL NAME(S)/INITIAL(S) SUFFIX\n\n_______________________________________________________________________ ________\n\n3c. MAILING ADDRESS\n\n___________________________________________________________________________________________\n\nCITY STATE POSTAL CODE COUNTRY\n\n____________________________ ______ _____________ ___________\n\n4. COLLATERAL: This financing statement covers the following collateral:\n\n_____________________________________________________________________\n\n5. Check only if applicable and check only one box:\n\nCollateral is □ held in a Trust (see Instructions)\n\n□ being administered by a Decedent's Personal Representative.\n\n6a. Check only if applicable and check only one box:\n\n□ Public-Finance Transaction □ Manufactured-Home Transaction\n\n□ A Debtor is a Transmitting Utility\n\n6b. Check only if applicable and check only one box:\n\n□ Agricultural Lien □ Non-UCC Filing\n\n7. ALTERNATIVE DESIGNATION (if applicable): □ Lessee/Lessor □ Consignee/Consignor\n\n□ Seller/Buyer □ Bailee/Bailor □ Licensee/Licensor\n\n8. OPTIONAL FILER REFERENCE DATA\n\n_____________________________________________________________________\n\n[UCC FINANCING STATEMENT (Form UCC1)]\n\nUCC FINANCING STATEMENT ADDENDUM\n\nFOLLOW INSTRUCTIONS\n\n9. NAME OF FIRST DEBTOR (same as item 1a or 1b on Financing Statement)\n\n9a. ORGANIZATION'S NAME\n\n_____________________________________________________________\n\nOR\n\n9b. INDIVIDUAL'S SURNAME\n\n_____________________________________________________________________\n\nFIRST PERSONAL NAME\n\n_____________________________________________________________________\nNANCING STATEMENT ADDENDUM\n\nFOLLOW INSTRUCTIONS\n\n9. NAME OF FIRST DEBTOR (same as item 1a or 1b on Financing Statement)\n\n9a. ORGANIZATION'S NAME\n\n_____________________________________________________________\n\nOR\n\n9b. INDIVIDUAL'S SURNAME\n\n_____________________________________________________________________\n\nFIRST PERSONAL NAME\n\n_____________________________________________________________________\n\nADDITIONAL NAME(S)/INITIAL(S) SUFFIX\n\n_______________________________________________________________________ ________\n\nTHE ABOVE SPACE IS FOR\n\nFILING OFFICE USE ONLY\n\n10. ADDITIONAL DEBTOR'S NAME - provide only one Debtor name (10a or 10b) (use exact, full name; do not omit, modify, or abbreviate any word in the Debtor's name)\n\n10a. ORGANIZATION'S NAME\n\n_____________________________________________________________________\n\nOR\n\n10b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME\n\n_________________________________ _____________________________\n\nADDITIONAL NAME(S)/INITIAL(S) THAT ARE PART OF THE NAME OF THIS DEBTOR SUFFIX\n\n_______________________________________________________________________ ________\n\n10c. MAILING ADDRESS\n\n___________________________________________________________________________________________\n\nCITY STATE POSTAL CODE COUNTRY\n\n____________________________ ______ _____________ ___________\n\n11. ADDITIONAL SECURED PARTY'S NAME or ASSIGNOR SECURED PARTY'S NAME - provide only one name (11a or 11b)\n\n11a. ORGANIZATION'S NAME\n\n_____________________________________________________________________\n\nOR\n\n11b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME\n\n_________________________________ _____________________________\n\nADDITIONAL NAME(S)/INITIAL(S) SUFFIX\n\n_______________________________________________________________________ ________\n\n11c. MAILING ADDRESS\n\n___________________________________________________________________________________________\n\nCITY STATE POSTAL CODE COUNTRY\n\n____________________________ ______ _____________ ___________\n\n12. ADDITIONAL SPACE FOR ITEM 4 (Collateral)\n\n_____________________________________________________________________\n\n13. □ This FINANCING STATEMENT is to be filed [for record] (or recorded) in the REAL ESTATE RECORDS (if applicable)\n\n14. This FINANCING STATEMENT:\n\n□ covers timber to be cut □ covers as-extracted collateral □ is filed as a fixture filing\n\n15. Name and address of a RECORD OWNER of real estate described in item 16 (if Debtor does not have a record interest):\n\n_____________________________________________________________________\n\n16. Description of real estate:\n\n_____________________________________________________________________\n\n17. MISCELLANEOUS:\n\n_____________________________________________________________________\n\n[UCC FINANCING STATEMENT ADDENDUM (Form UCC1Ad)]\n\n(b) A filing office that accepts written records for filing may not refuse to accept a written financing statement amendment in the following form, except for a reason set forth in section 490:9-516(b):\n\nUCC FINANCING STATEMENT AMENDMENT\n\nFOLLOW INSTRUCTIONS\n\nA. NAME \u0026 PHONE OF CONTACT AT FILER (optional)\n\n____________________________________________\n\nB. E-MAIL CONTACT AT FILER (optional)\n\n____________________________________________\n\nC. SEND ACKNOWLEDGMENT TO: (Name and Address)\n\n____________________________________________\n\nTHE ABOVE SPACE IS FOR\n\nFILING OFFICE USE ONLY\n\n1a. INITIAL FINANCING STATEMENT FILE NUMBER\n\n_____________________________________________________________________\n\n1b. □ This FINANCING STATEMENT AMENDMENT is to be filed [for record] (or recorded) in the REAL ESTATE RECORDS.\n\nFiler: attach Amendment Addendum (Form UCC3Ad) and provide Debtor's name in item 13.\n\n2. □ TERMINATION: Effectiveness of the Financing Statement identified above is terminated with respect to the security interest(s) of Secured Party authorizing this Termination Statement\n______________\n\n1b. □ This FINANCING STATEMENT AMENDMENT is to be filed [for record] (or recorded) in the REAL ESTATE RECORDS.\n\nFiler: attach Amendment Addendum (Form UCC3Ad) and provide Debtor's name in item 13.\n\n2. □ TERMINATION: Effectiveness of the Financing Statement identified above is terminated with respect to the security interest(s) of Secured Party authorizing this Termination Statement\n\n3. □ ASSIGNMENT (full or partial): Provide name of Assignee in item 7a or 7b, and address of Assignee in item 7c and name of Assignor in item 9. For partial assignment, complete items 7 and 9 and also indicate affected collateral in item 8\n\n4. □ CONTINUATION: Effectiveness of the Financing Statement identified above with respect to the security interest(s) of Secured Party authorizing this Continuation Statement is continued for the additional period provided by applicable law\n\n5. □ PARTY INFORMATION CHANGE:\n\nCheck one of these two boxes:\n\nThis Change affects □ Debtor or □ Secured Party of record.\n\nAND\n\nCheck one of these three boxes to:\n\n□ CHANGE name and/or address: Complete item 6a or 6b, and item 7a or 7b and item 7c.\n\n□ ADD name: Complete item 7a or 7b, and item 7c.\n\n□ DELETE name: Give record name to be deleted in item 6a or 6b.\n\n6. CURRENT RECORD INFORMATION: Complete for Party Information Change - provide only one name (6a or 6b) (use exact, full name; do not omit, modify, or abbreviate any word in the Debtor's name)\n\n6a. ORGANIZATION'S NAME\n\n_______________________________________________________________________\n\nOR\n\n6b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME\n\n_________________________________ _____________________________\n\nADDITIONAL NAME(S)/INITIAL(S) SUFFIX\n\n_______________________________________________________________________ ________\n\n7. CHANGED OR ADDED INFORMATION: Complete for Assignment or Party Information Change - provide only one name (7a or 7b) (use exact full name; do not omit, modify, or abbreviate any word in the Debtor's name)\n\n7a. ORGANIZATION'S NAME\n\n_____________________________________________________________________\n\nOR\n\n7b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME\n\n_________________________________ _____________________________\n\nADDITIONAL NAME(S)/INITIAL(S) THAT ARE PART OF THE NAME OF THIS DEBTOR SUFFIX\n\n_______________________________________________________________________ ________\n\n7c. MAILING ADDRESS\n\n___________________________________________________________________________________________\n\nCITY STATE POSTAL CODE COUNTRY\n\n____________________________ ______ _____________ ___________\n\n8. □ COLLATERAL CHANGE:\n\nAlso check one of these four boxes:\n\n□ ADD collateral □ DELETE collateral □ RESTATE covered collateral\n\n□ ASSIGN collateral\n\nIndicate collateral:\n\n9. NAME OF SECURED PARTY OF RECORD AUTHORIZING THIS AMENDMENT - provide only one name (9a or 9b) (name of Assignor, if this is an Assignment)\n\nIf this is an Amendment authorized by a DEBTOR, check here □ and provide name of authorizing Debtor\n\n9a. ORGANIZATION'S NAME\n\n_____________________________________________________________________\n\nOR\n\n9b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME\n\n_________________________________ _____________________________\n\nADDITIONAL NAME(S)/INITIAL(S) SUFFIX\n\n_______________________________________________________________________ ________\n\n10. OPTIONAL FILER REFERENCE DATA\n\n_____________________________________________________________________\n\n[UCC FINANCING STATEMENT AMENDMENT (Form UCC3)]\n\nUCC FINANCING STATEMENT AMENDMENT ADDENDUM\n\nFOLLOW INSTRUCTIONS\n\n11. INITIAL FINANCING STATEMENT FILE NUMBER (same as item 1a on Amendment form)\n\n_____________________________________________________________________\n\n12. NAME OF PARTY AUTHORIZING THIS AMENDMENT (same as item 9 on Amendment form)\n\n12a. ORGANIZATION'S NAME\n\n_____________________________________________________________________\n\nOR\n\n12b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME\n\n_________________________________ _____________________________\n(same as item 1a on Amendment form)\n\n_____________________________________________________________________\n\n12. NAME OF PARTY AUTHORIZING THIS AMENDMENT (same as item 9 on Amendment form)\n\n12a. ORGANIZATION'S NAME\n\n_____________________________________________________________________\n\nOR\n\n12b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME\n\n_________________________________ _____________________________\n\nADDITIONAL NAME(S)/INITIAL(S) SUFFIX\n\n_______________________________________________________________________ ________\n\nTHE ABOVE SPACE IS FOR\n\nFILING OFFICE USE ONLY\n\n13. Name of DEBTOR on related financing statement (Name of a current Debtor of record required for indexing purposes only in some filing offices - see Instruction for item 13 - insert only one Debtor name (13a or 13b) (use exact, full name; do not omit, modify, or abbreviate any word in the Debtor's name)\n\n13a. ORGANIZATION'S NAME\n\n_____________________________________________________________________\n\nOR\n\n13b. INDIVIDUAL'S SURNAME FIRST PERSONAL NAME\n\n_________________________________ _____________________________\n\nADDITIONAL NAME(S)/INITIAL(S) SUFFIX\n\n_______________________________________________________________________ ________\n\n14. ADDITIONAL SPACE FOR ITEM 8 (Collateral)\n\n_____________________________________________________________________\n\n15. This FINANCING STATEMENT AMENDMENT: □ covers timber to be cut\n\n□ covers as-extracted collateral □ is filed as a fixture filing\n\n16. Name and address of a RECORD OWNER of real estate described in item 17 (if Debtor does not have a record interest):\n\n_____________________________________________________________________\n\n17. Description of real estate\n\n_____________________________________________________________________\n\n18. MISCELLANEOUS:\n\n_____________________________________________________________________\n\n[UCC FINANCING STATEMENT AMENDMENT ADDENDUM (Form UCC3Ad)]\n\n(c) A form that a filing office may not refuse to accept under subsection (a) or (b) must conform to the format prescribed for the form by the National Conference of Commissioners on Uniform State Laws.","path":["Hawaii Code","Division 2","Title 27","Chapter 490"],"source_url":"http://www.capitol.hawaii.gov/hrscurrent/Vol11_Ch0476-0490/HRS0490/HRS_0490-0009-0521.htm","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:11Z","sha256":"9b6ab94393f08d466ff4c73e56fc6553a96883b33bbbb16ed9b9939ae0ac8134","source_id":"us-hi","stale":false,"prev":"us-hi/haw.-rev.-stat.-490-9-520","next":"us-hi/haw.-rev.-stat.-490-9-522"},"notice":"GroundRules: Original legal text. Not legal advice."}