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Home My WebLink About0862 i ' e i t iy 5 ~ 2 fi ~ : F~'vA1J~1fJG SSA7_MENT :s presm'ed +o a f~i.np oif:cer for f~l .r,~ p~.nua+t ~o rt» llnifc.m Comrne~r,a! Code: I 3. M~~~r~~~ aare (_f any): ~ .u-~c*orlsi :iust t~:..m.e Fuss~ and odd:ess;es) 2. Secyred Portyl~es) ond oduresst~) , for F~I,rp Otf~cx (Dat~. T~~rr. Nvmbst, cnd F~lirp Officr) < ~ Provi~se*:t ~inance ••ompany ~ ~ :~^;:ail~ shir?e~~ ?2 Or~.~=:~ i{ver.ue # ~ ~ 7n3 ~:ortn 1~th Street 7- ' FIlEO ~MO RECOIt~~` ~ ro^t ~iarce, Flo:-ida EL~UC~E COUMIY t~. ~ ~ r~rt Pi rce, Flori~a IIOCE~ POITRA~ ! ~ ~ c~~RK c.RCU~t covRt~ : ~ P,ECOF,Q VER~F~EO.....~~ ~ ~ A j ~~-.,s f:nonc~:rp staternent cu+ers ths folbw:^fl tYPe~ fv ~tems) 01 D~~Y: ~ ~ ~ J. A~1 uf tne hcusEho:d qoods rww o hefeof:er docatec ct debtor's residurcs oddr~ss set forth obove. ` i ;c~ ; i l -~-4 ~'~.r. p'oTkr'Y dew~bed a ± S_ Ass;pna~ts) of Secwed Purty and Addressl~l : ~ ~Item) ~ - ~ ~ ~ . C:.nack ;f rr„e i$ Tns stan+ps rsqu~reo by Chopse~ 4(21. F.S. hev~ be«+ ploced on ihe Prom+ssory ins!ruments secu:ed 1 - ':i ~.erebY, v~~d w~ll bs ptoced o~ ony add~t~anal and s~milar irstrurt~ent rAat moy be so sacvred. ~ ~ - - - - "n:s saa+er.,ent :s f~ted w~rAwt rM debror's a~anotur~ to pe•4eo o sewnty irx~r~sf m cdlateroL (Ch~cic ~ if so) Alreody s..b;ect to a s~cunty ~nirest tn orwrher ikisd•U~~+ when it wns broupht info thes stats. ~ ;J .vn.~ ~s p«eeds oF tM or~y,nol wlloteral d~acr~beo abure m wY~d~ o ssc~rity inis~est wos per4ected, - - - _^-Jc „~f CG.CCO: ~ Praeeds of Collatrol or~ olso co~red. ['j Prcdvcts of Go14otKO1 we ol~o wv~red. No. af odditiona~ Shcats pro.'ented: _ F,kd w~M: - J±. ull^12 vo~_1_^.' ;•`~1?"trOUBo - w _ ~ _ ~ J;~i.,~c,; :apn l t~2'^ . .t rinAnr~+ :~C!_ ^.~!1V ~ - _ I _ /'f~ / _ o _.~.c'f~~- _ r' ~ '_4 , .Cf~-{~ ' i ~..=a - S.flnat ets) d Debiw(s} - pnotw~(~ ~ „~:~;•a of+:~•• covr -.?~~,hae~r~~at STANDARD FOiiM - UCCr-1 - /lppirovad by TOIA AD/1MS. S~cresu-~ ci _ - ~ - ~ . . : _ _ _ x~_'~,~~~.