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- _`;NAfKING STAT:MENT es prosensed to a f~i~n~ officer fw fiGng po+swnt to tha Uniform Commerciol Code: I 3. AA~tv if '
~c• .r(sJ ~iast ttiu~r,e f~nt) ond addresstes) 2. Secured Portylies3 and oddress(es) ~~~9 i ilitp Oifip)
•pF E cOUNTY F~a,
Jordan, Marie General Finanae Ican Ccn::~nsy C 4 R R ~ F• E O
2012~- Orange Ave. 2401 South Federal Hwy 1+~~~
F~. Pierce, Fla. 33450 Ft. Pierce, Fla. 33450 '
69 Jt~#~ 10 AN 9: sg
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T~-~s i+nux~ny srotcment cwers rhe follcwiry rypes (ar rtcros) of poperty:
` CLERK E~ rOiTRAg
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~;~+i: of tne ho~xhotd qoods rww v hcreafter located ot dcbtor's residence oddresa sat forth obove. Ci+ CO~
RCUIT 4
~ ; Chha~ prcprrty desv~b.ed a~ 5. Assisnee(s? of Secured Porty ond Address(es) '
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~ :~eck if tr~e rj The stamps reqvir~d by Cf+apror 201, F.S. have been ploced on tM pr«tisswY 7nsrrumeMS s~cwed
'~y ~'ebY. nnd w~ll be placedron any additional ond sim~iar instr~rrx~t tiwt rray be so ucured. l
~ t stoternen; ~s f~!s! w~shout ths d.b!oi s s~pnoTure ~o perfea o security interesf in colbterol. (C~Kk ~ if w)
~ Akeo~y su5jrct to a seaw+.y intwest ~n onotha ~w~sdlU~on vr#~en +t wm brovqht inro this stots.
v.~+ich is prxeeds of tha ory~nal coflo!erol dssu~bed obo.s in wh~d~ o securiry interest was perfected:
~ -.r.k =i oo•:ered: Pr«eeds ot Gol{~rerol we alw covered- ? Prodxts of Collar~rol are also coverrd. No. of odd~tional Stxeta pssentsd:
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GEI~L FI S LO ANY
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2i=-- . S !u~ Of ~!I
•(s) of Debtor(s) '~na1'x ~
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' STANDARD fORM - FORM ~1CC-1
~ (1 i Fihno Office~ CoPr - Alplwbe~icol ~
ApproveC by TOA1 AD/1MS. Secre'o-.
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