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STATE OF FLORIDA
UNIFORM COMMERCIAL CODE - FINANCING STATEMENT - FORM UCC - 1
TNIS FINANCING STATEMENT is presented to a filinp officer for filing pursusnt to the Uniform Commercial Code: 3.
t. pebtorls) (lest Name First) Address 2. red Party ~nd Address . For Filing OffioertDate, Time, Number,andFiting
l ~ - ~ Office)
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4. This financing statertient covers the following types (or items) of property~ /Check 6ox which appltesJ
All oj the huusel+old furnitu?r and furnishing; e(ectrical and gas appliance; including televfsion
setx phonographs and record playtrt rrlr'igtrntorsti etc.. and other pomnal p~op~rty noN ownrd
:J or htnajter ut~uired in replactment thtxoja»d now• or henajter located at ihe residence oj the
Debtors at thr addrest Rfvrn abo~ti in Box l.
I 5~ Auignee(s) of Secured Parry and Addresslesi
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( 6. Checlc if true[x'~ The stamps required by Chapter 201, F.S. have been plsced on the promissory instrument
t secured hereby, and will be placed on any additionsl and similar instrument that may be so sewred.
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~ Tn~s scatemer,t is filed withaet the Debtors signature to perfect a security interest in collateral. (Check ~x if sa)
? Already wbject to a security_ interest in another jurisdiction when it was brouyht into this stata
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~ ? which is proceeds of the original collateral desc~ibed above in which a sscurity interest was perfected:
~ C heck x if carered: Proceeds of Collate?al are also covered.OProducu of Collateral are also oovered. Na of additional Sheets praented:
~ r i ted with: Clerk oj the C" it ourt oj Counry, F7orfda
~ t Secured Perty *
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~ Debtor gTqNDARD FORM - FORM UCC-1 Manage
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