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g F;ivq.\~iP+Ci STA~:MfNT is pfeur!eti ro a i~:•rq ofi.:er ~y f Lrq p~,~swnr so ~he ~;n.f:.m. Cc+r~~+erciul C~: ~ 3. Nbr~nry do~s (if aeY): i
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~ -crar~al llost :~.crr~e F~rst) ond JCli3~E3i\ES) ~I. SMi+ed Purty(~es) ond add:nss~esl ~ Fo. F~I~r Oif~ter (Date, i~ms. Ntimber, om~ Fil~r.p Offite) .
' Frov: .e^t = i~:a-.ce Co,:,pa.^.y ~
~ ~ .-.r_~e ~ l r,.e;;~:ie
~ _ ~o~ l, .pt+V 7%~ ura~-~A '!yP ~~P ~ f ~EO ANG RECWtQE_ 4 U
~ ~~.IUCIE COUMIY FLA.
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~ ~13 '-ct*.: %~t~: : or± rier^e, L~] or~ ~ AOCER ?O1Tfl~~ i
~ r,~ ' _ CIERK C1Ri.U1T COU~T '
= o~i : i . = _ . _ ~ f RECQ~D vra+f!E~
~ - ~^~~.s 4,nar.c~np s~v~ement co-.ers r~e fo~Sow:rp typea ior ~*er.:s; of properry: -t i
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~ Aff of tne tu~~xheld ~~d~ now or hereof~e~ iocnted at debtor's res~defxe «idress set fw:h abc.e.
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;:i+~.e. pr_;,~ry dew~bed c: ~ S. A~sayne~(s? of Secwed Porty ond Addreu(as)
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- ~r.r,k +f +r~e ~ TM stomps flG,i~fld Dy ChOP!K 201, f.S hove Cem Diax.ed cn me .~romi?say instrvments sec~red ~ ~
•.ercoy, ar.d wiil Ge pioced w: on/ oOd~t:;ncl ond ~~~n~Ior ~nstrvrnent that r~ay be so arcured. ~
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'~.s a:aterr~.rnt Is f~kd wirhovt ~ns deb!a's s~9nat~r• to perFect o secunty int~~est in cd{aterol. (Check ~ if so) '
~ Afrsody s~o~cct to a securi!y ~nte:est in orx~!her junxl.u~on when it was bfo~qht into this state_ '
w.^.~ct; ~s ~+occeds af tne c~:9~nol wilaferol danv~bsd obo+e m wn,c1~ o sec~~;ty ~~tereu was perfeded:
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' -_k ~f u:rred: Y} Proceeds d Col{aterol a~ uiw wweved. ? Products of Colbterel ore alw wve~~d. No. of oddit~uw~ Shetif p•ssmtsd:
a Fited wiM: - ~ u•.-: p ~nt~n:.~ i,~`,.Zrt~!)~. p ~
- BOQK PAGE~146 . . .
~ Pt+. i±c-.eil ~ vi_:ert r,n?nce ~;oryn.~~~y
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S~Qnat~ro(s) d Debtc.~s) Siynmuro(s) of Secured P (i~s)
- j, r,i.~~ oc~~, c STANDARD FORM - UCC-1
opy ~ Alnti~bel~ccl
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APPrwrd bY TOM ADAMS. :»crr'- ' ' '