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iH15 FINANCiNC; STATEMENT is pr~s~nbd M a filiay officer tor fil;np qrrwant ro Nr Unifonn Co~rwKCiol Code: Matvriry do1~ (if on~):~.0 .4 ~
D~blw(s) (losf Naw~ Fint) and ot~dress(y) 2. S«vr~d ~ortrlies) ond oddr~ss(a) tw a'ry ON:ar :Dw. rr. N..br..w~ iaw~ Oftcn)
, Eugene C. 8utton and Joan Charles H. Ssselstyn and 153062
L. 3utton~ his wife Adele J. Ssselstyn, his w e _
912A Tumblin-811ng R,oad 608 8. lfilloWS Ave. ~
~ Fort Pierce, Florida Fort Pierce, Florida
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` 1. Fhis fieoncino s~ohw~N covKS 1h~ follo~i+q ~rVp lo~ iNrwsl oi i~op~Ay:
~ See Schedule A attached hereto and made a part hereof ~
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S. Asipn~~(s) ef S~cvr~d Io~ty ond Addnss(~s)
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6. CMc~ if Mw~ iM stan~Ps ~pwnd M ChapK 101, F.S. how ~w ploc~d en /M pa~issory imtnwww~ls s~cw~d
h~r~bp, owd wiil 6~ piac~d m onr add'tional and sirwilor imhrwwnf tl+o~ war b~ so s~cvr~d.
ihis sbt~a~a~~ is fibd wiNavt Nr d~Moe's aiqnoNr~ a~rf~ef a s~arriy iwt~t in colkAwd. (Gh~ck ~ if w)
p Ak~ady ~rbNc~ ~e o s~curiy inw~st in onatw io+isdidiaw wMw it wos b?wqh~ i~MS dus sbM.
p.?hid~ is precNds eI N» eriyiwol co11aN?ol d~saib~d abow in whid~ a a~cwity iM~st vuet owhcMd:
Cti«k ~ H cm~M~d: ??rocMds of CollolKd an dw cawr~d_ ?/rodYCts d Collo~wel an olso oow~~d. No. of odditia~d Shwfs pns~nhd:
F:~.a w~ti: O ce o t e er o e r-cu ur , . uc e un y, F ori a
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~ 6r~ SiyMwn(~) of O~Mw(.) er~ p1 oi ?«+~(i~s
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' F~ing Of/ker Capr • p~lwyffjpa n rr •
6U0~ 1 4 PA{jC z~~ Approv~d b/ Taw Adows, S~crNOry of Sla~e, S+oN of Florida
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