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IS STATfMENT is pru«+Nd 1e a filiig dficer fa filin~ pwsuoM to IM Uwiforwi CoerwKCiol Cod~: Moturit~ do~e (if my1: ~
1. pb~or(s? (tast Nawr Pusf) and addre~s(~s) s.~,~..a ?~.~„i+~+~ ~aa...s~.~~ ~p ST, lUC1E COUNTY. FLA.'' ~
~~1 ST. LUCIE COUNTY BANK RE:C~RQ V~RIF~ED
fio r~.~.~a~? st~t, P. o. eox s 165`791 '
~OM~ FORT PIERCE. FIORIDA 3 3 4 51 .
68 APR 3 AM 9. S 0
' 4. Thif ftofMMf ?t~M /0 inol F' 1~~ ~~`'~C~
°"y S'°""'e"' b'°""° fib ti°. 0~~ F. ~ U( i R ji S
. ~~i.a.,~x~• Lrtofe Co~ott~~ lla. ow.~~a ~ u w~_ CLERK CI
= S. ~ ConfirNratioo: TM oripina! financin~ itotNnent b~hrNn ~nyany nd ?ortr, bwring fik rwa~ber slwwn abor~, is still ~1fMiw.
; 6. lenninotion. S~cw~d parh no lony~r cfoims o s~cvidp inNnst wdw tM Finencip sbt~nt bwriny filt ~wmber shown abo+~.
> 7. ? Asi~yneMnt. TM s~tw~d pwb"s riyM vwdM Nr finoneinp sat«w~M bwiiq fil~ n~e~b~r slawn abow to M» p.ope.tY d~tcrib~d in IHa I1 hos b~M osi~yn~d
b?M ossiQnM whos~ now~ ond addr~ss appwr in Ihrw 11.
' 8. ? Anyndinent. financiny SM1~eM bwrieq fib nu~bw shown abow is awynd~d os fM fwth in It«a il.
~ 9. ~~os~. S~cw~d ?arryr nl~ases th~ colloNral describ~d in It«w 11 fraw tM Hnoncinq sta»n~nt bwriny file n~~nb~r shown abow.
; 10_[~Check if hw. All docvwwwtwf stawp toa~s dw and pos~ or lo b~cow~ dw ond PoroW~ p~rsuanl b Chapftr 201, F. 5. hor~ bMn poid.
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' 19fo Staroratt H~lida~ Boat - S~r #94S1o226
E 1 'Prail~ae
~ 1- 4~ Hr ~.saraa• l~ot.r, lisda 35~. ~4-79a
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p No. of odd~tionol sMNs p~MnNd:
ST. LUCIE COUNTY BANK
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~ S:y~wwr~(s) of O~bt«cs) tnwssory onlr if Nwn t is applicobb). T1 ~r `s) o S~a rtws)
STANDAR~ ~0~/1~4j FORM
~ (1) F~iny Offie~r Copy - AfphaSstitO~ 6Mr r~ PAP[ Appro~r~d br fOM ADIUMS, S~er•rary of Stoe~, Star~ of Flw;do
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