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; -~=iYANGiNG STATEMENT is presenred to a filiny ofiicr for fiir~y p~rsuont ro she Ih+~fwm C«nrnarcial Code: 3. Motwity dats (if any):
~ ~eotwis) llost tVarne First3 ond odd~esa(es) 2. Sewrd Partyliss) ond oddress(es) Fd Filirp Officer lDat~, ii~n~. Nwnber, ond fil~rg Offics)'
~ ~~^x, Ursu1R Previder.+ r'inar_ce ~o^~n-:ny f
-~16 9. N. 22nd ijlf0 tfNQC~ ' }
722 Oran;~e Hverue ST
~ rort Pi°rce, Flori~~a ro~t Pierce, rlori~a s
~ ERI~ ~IRCIM~ D~M~'n i
~ ~Rp'~{Rlf ifa~Mi~~ ~
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. -*+~s finaxinp stoterront covers ths (o?bwinp rypss (a ~taT~s3 ~ WW~TY+ +q`A~`~~
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~ i All of the lwusehold yoods rww v hereofter locoted at deb:or'a residencs address sst forth obo+e. I F
~ ~ Other propxty dewibd S. /l?s+9ne~(s) of S~cvr~d Partp and Addrasa(ss)
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~reck if trw TM» stomps requir~d by Chopter 201. F.S. have bean plae~d an d» prw++~a+wY insrrvrne~ts a~ox~d
he~ebY, ond will be placed on ony odditiona) and aimilor i~strument thot may b~ so s~a+r~d.
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~E -n.~ stoternent is fikd witAwt tM debtai s s~p~at~n ro perfed o a«urltp ir+t~est in cdlot~raL (C]ydc ~ if ~o)
J Alr~ody svhject to a ssa~r~ty imferesr in onother iurisdxtion when if wm bro~piFv inq this stat~.
~ wfiid~ is proceeds cf the wpinal mlloterul dsscr~b~d obors in wf~id~ o~scwiryr i~terpt woa qrfWad~
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~ r<:k ~ if covxed: ~ Procesds d Colio!eral ars o~ao oorersd. ~ Products oE Colbe~ral ors olw cowr~d. No. of odditiano{ SM»ats pr~su~s~d:
~ ~'_~w~"~= St. Lucie County Courtnouse
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~ tirsul~ Cox R Provic~ent Finance Cor~aany
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a.._ ~~~IJ u,Q2 Ct97~( sy lit,/~
~ Siprwnx s) d O~Ww(s) Sivrwt~n(+ ~d Pwtp(i~s)
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!1~ i;C~ OF}'~cer C Alp6abet~cal `~AN~~~ F~M ~ '
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MV~a~ b'Y TOM 11DMA5. S~cr~sor> -f ` _ _ . , -
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