Office of the Minnesota Secretary of State UCC Secured Party Search Request _____________________________________________________________________________________________ Company Name _____________________________________________________________________________________________ Contact Name _____________________________________________________________________________________________ Phone Number _____________________________________________________________________________________________ Address City State Zip _____________________________________________________________________________________________ Email Address When the order has been processed, an email notification will be sent to the email address listed on the request form. The email will include a link to the secured party search results. Results are in a PDF format. The fee for a Secured Party Name Search Statewide with debtor information is $ 170.00. List the Secured Party Name to be searched below: (only one name per form). You may limit your search by city or date range. Organization's Name ___________________________________________________________________________ Individual's Last Name ________________________ First Name ___________________ M __________________ City _______________________________________ Start Date _______________ End Date _________________ Please make check payable to the MN Secretary of State and mail form and fee to: Office of the Minnesota Secretary of State - UCC Retirement Systems of Minnesota Building 60 Empire Drive, Suite 100 St. Paul, MN 55103 If you have any questions, please call 651-296-2803 (Twin Cities area); or 1-877-551-6767 (Greater Minnesota) and press option 4 for assistance. Phone lines are open between 9 a.m. and 4 p.m. M-F excluding holidays. All of the information on this form is public. This document can be made available in alternative formats, such as large print, Braille or audio tape, by calling (651)296-2803/voice. For a TTY/TTD (deaf and hard of hearing) communication, contact the Minnesota Relay Service at 1-800-627-3529 and ask them to place a call to (651)296-2803. The Secretary of State's Office does not discriminate on the basis of race, creed, color, sex, sexual orientation, national origin, age, marital status, disability, religion, reliance on public assistance or political opinions or affiliations in employment or the provision of service. Rev. 9-2016 American LegalNet, Inc. www.FormsWorkFlow.com