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?HIS FINANCINC> STATEMENT is prexnted to a fi~:nq oificer for .`il~n9 pursuant to the i.iniform Cornme~cial Code: ~ 3. Mat~rity date (if any): ~l
i. Debtor(s) llost Nome F~rs7) end oddressVes; 2. Secu+ed Partyi~es) and oddreu!es) Fw Fiiirg Oifiter (Date, Time, Number, and Filinfl Of(~ce) ;
gII~TRA2~` DpRS~'TT GE?~AL FIN6NCE IA6N C02~~A1dY FI D ANO RECORDEDI
ANNIE B. DOR.S~T'T 2401 S. FEDERAL HIIHWAY ST. UCIE COUNTY. FLA:' Z
1~650 38th COURT FT. PIII{(~, FIARIDA 33450 ~ P D`I~ R IFI F D }
VERO BF.kCH, FLORInA 33450 186432
This fio~nc:nq s:a:cment cwers the follovring types t~ itc+ns) of properiY: ~ ~ ~ Sg V~ '
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[j All of ihe hcuxhoid qeods now w ~ereofter iocated at deb:or's:esidence oddreu set forth o~~~. ~~OGE~ POITRAS _
j_j O;n:r prop..rty dasvibed ~s - CL RiC Ai6i~JfFf ~=^y o^d 1`doress(es) ~
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3
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6. Clrocfc ~f tru- Tha stwT+ps requ:ced by C1~apter 201, F.S. Aove bee.~ ploced on tne pom~ssory ~ns'r~rnents ucured ~
hereby, and w~ll be ploced w+ ony oddit~orwl and sim~lor instrunient tF.at may be so uc~red.
Tn~s sfatem.ent is filed wrhwt rhe decror's sq~ature to perfect o security mterest in cdbteral. (Chedc ~ if to) • ~
? Alreody subject to a secunry :nierest ~n crrotlrcr junsd:cfion when if wos bo~qht ~nto this srate.
~ wh~ch is proceeds cf the oriq~:wl cn~tateral desu.bed oba+e i~ whid~ a security inte+est was perfMed: ~
Cl~ecic ;y' if cerered: Procreds of Co!~aterol ore oiso co~ered. ? Prcdvcts of Col!a!eral ore also coYered. No. of odditwnal Sheets presented: ~
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Fikd with: ~
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~'C $iqnatwe(s) of Debtw(s) Siynatw~(s) of Secured Party(t~s) ]
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F~I~~g olferr CovY -~'~phobeticol STANDARD FORM - FORM UCC-1
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