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~ HIS STATEMENT 7s prn~nNd ro o filiny ofiicer fw filiny qrrsuwif io tM UniForm COrwiMrtio) COdt: 3. Mahrtify date ff o~r}: 1~ ~ Q
1 p~btaltl (losf Nowr first) and oddr~ss(es) 2. S~c~red torty(i~s) ond oddress(~s) F' ~.'~"V°~~ ~~Q~~~~
ST. LUCIE COUNTY, fLA.
~~2livan, John J. LUCIE COUNIY BANK ?=-:^nf?i` L~~RlFrED
? 012 S. l lth P. O. BOX 8
~ . Pierce, Fla. 331~5~ 18$`Z'~`2 ~
FORT PIERCE. FLORIDA 3 3 4 51 +TO JA~~ ~ 3 ~ y5 i
t This sbte~nf r~fen fo o~iyinol Finoncieg Sta~ement beori.g Fib No_~~~,7~~ ~
`;O:,E:? ~OITRAS
w;~, St, Lvcie Count F; Dec ~9~i3_
5__ Continuafion. TM orqinol fiwoncing stotunen~ betw~an the fw~yoinq Debfor ond Sscvnd Pa~ry, bwr:nq iil~ ewmber showe abow, is still ~fftctir~_
6~ Terminafion. Stcvred poAr no bnqer dairns o s~owity infer~st vndar the finoncirq stafement bwrinp iitt ewmber sFww~ obove.
_ Assigmnenf. The sKwed partp's riyM vnds~ th~ finawciny stat~t bwrinp fib nwnber shorm obow lo Hx property d~scrib~d in 11em 11 has b~~ ossiqn~d
~ ro Itr asignet whos~ ~ and addr~as apWar in INrw 11.
~ 9~' Amendm~nf. F'r~w~ciny Sw~ement 6~winy file rwmb~r sFarn obev~ is ainMd~d as s+t Forth in Ihrn 11.
~ r:~; R~I~os~. S~cw~d Iwtr relemes 1ht colloMral d~stribd in It~m I1 from the finwciny sto»~nt Moriny fiM o~mber shown abow.
t0. Check if trw. All d«~~+wry itanp roi~s dw and parobb a w b~cane dw and voroW p~•wam ro Clwpe.. 201, F. S_ 1~w~ bMn puid.
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No_ of oddifional sMMs p~wnNd:
ST. LUCIE COUNTY BANK
~ 8y, tr:
S:qnahwe;sl of D~Mor(s) iMCesswr wdr if I~em t is opplicoble). S~ynature;s) ef S~cw~d ~wtfr{iesl
STANDARDQ F~ ORM j~
(1) Filing O~cer Cepy • Alphabetito~ ~OQ~~~~ ~H~E ~-fAVP~ored br TOM ADAMS. Secr~ta.y of S~ote. S~a!e of flo~~do
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