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THIS FINANGNG STATEMENT is prexnted to o filinq offiwr fa filirg purwont to d~s Unif«m Corrrnercial Cods: ` I` 3• MotwltY dot~ (if any). w~7S -
i_ O~bto?(a (lost Nwn~ Fitat) a+d oddrsss(ss) 2. Swxd Part~(iw) ond oddr~ss(~s) - For FiW~p Off~ter iDm~. T~ms and Ftlup Off~n)
Gg~y gj~g j~p C~~ 1LED Af~D RECOR~~ n
S~SITH, JAMS3 0. ~ uC1E COUF~TYr^LA.
3NII1'B~ I$IA ~LL OF FT. PISR(iB L n•; ; F' c r~.
RQU'!`L~ -B41C-321 - _ _ _ 2401 S.. FEI~L ffiGFiWAY--- - - _ - ~~~'i~82.----- _ _
FT. PZSRC~S, FLORIDI? 33k50 FT. PI~CB, ~LO~tID~ 33450
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4. Thb finoncinp statemanf cov~rs tM foibwinp lypss (a items) of prapKtY~ `a
~~~J Ll;1/
~ AU of ths houaaliold yoods raw a hereaher locoted at d~btors rtsidence ocklress sN forth abov+. r, j~: J
and Addrass(~s)
Q .Othar WopatY das~r~bed (lirn)
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6. C3~dt if tru~ Q TM s1m+W requir~d by Chopter '101, f.S. hav~ b~en Ptaced on tlr Pr~TM~Y insm~wrwras sscured ~
Frr~by, ond will b~ piaoed on a~Y additi«wl and sim;lor irotrun~nt eFwt may b~ ao s~cwed.
This stotemanf is fibd wid+ovt tM dsbtars siynatur~ ~o psrfe~t a sscurity in»r~st in cdlot~rol. (Ch~ck ~ If ao)
? Ak~odY subled a a s~dxiq intrest in anathK i~adidion wF»n it wos broupl+t iNO thb stat~.
wluth is procMds of th~ oripinal aollotarol dawibsd obovs in vrh+d~ o arcuriy inMest wos PKf~ctd:
GAadc ~ if awered: O Praads of Go1latKO1 ars also oovered. O Prod~cts of Collat~rot ar~ olao covred. No. of odditionol SM~ts pas~nt~d:
fi4d vrith: '
~ o ~iAL E IAAN C OHII'ANY OF F'T. PIII~CS
B,, --+e.(~~ ° s+~.ca of s.a,..a r~+,,c+«~
Sipnotur~(s) of (s)
Fa~~ oF~.. c~ - ~~~+~o~ STANDARD FORM - FORM UCC-1 ~00~~~ ~f~~
Apprw~d b~ ipµ /?pI~MS, S~creto,•y of Stote, Stota of Fbrida :
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