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Bor24L-1 Ed Mrty'70
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pFCOkU VER~f~ED~¦.¦~~i~w
Mw 20 t0 0~ A~'13 zs881i
STATE OF FLORIDA
UNIFORM COMMERCIAL CODE - FINANCING STATEMENT - FORM UCC - 1
THIS FINANCING STATEMENT is prosented to a filiny officer fo? filinp purwant to the Uniform Commercial Cods: 3.
t. Debtarls) lLast Name First) snd Address 2. Securod PartY and ~?ddross * For Filirg Officer(Date,Time, Number,andFi~iny
Office)
g, : Fen:+n: ~~w ot Fort 1`irrcP
,::ic~ Jr. ::arol i;i J~:r-~l , t;~. 3 a3o
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4. Th is financing statert~t cove?s the following types (or items) of property: (Chrck box which applies)
A!l oj the househdd firmrtvrr and furntshln~ ef~ctrica/ nnd aas opplla~ce; tncfudirta tNevcs~on
se~ phonognophs and nrord pluyen` rcjriaeroton~ etc , cnd other personal property now owned
~ or henajtes ncquind in nplacenfent fhertojnnd now or her~ojte~ located at the nsidenct oj thr
Debtors at the addrcss ~i?rn uDo?~t tn Box 1.
~a Assigneels) of Saured Party and Addressles)
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~ o. Check if ttue~ ThE Start~pS tBquilBd by ChBptK ZO~, FS. hsve been plsced on the promissory instrument
secured hereby. ar?d will be placed on any sdditional and similsr instrument that may bs so secured.
E Docun~rntory .rtanps ottached to odaLisl note and cancell~d '
! This statement is fikd without the Debto~ signature to perfect a security interest in collatersl. lCheclcQx if so)
j ? Already wbjece to s security interest i~ another jurisdiction when it was brou¢~t into this sma
~ ? which is proceeds of the original collatenl described abwe in wfiich a security interat was pe?fected:
~ Check[lif covered• Procesds of Collsteral are alw covered []Products of Collateral are also ""~ed Na of additional Sheets Presented: _
~ Counry, Ffodda
~ F i led with: Cltrk oj the Circult Court of
~ sew?sd Psny * . •
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Debtor . STANDARD FORM - FORM UCC-1 y
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