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- STATE OF FLORIDA
UNIFORM COMMERCIAL CODE - FINANCING STATEMENT - FORM UCC - i -
TNIS FINANCING STATEMENT is presented to a tilinp offiter for filing putwant to tl~e Uniform Commerci3l Code: 3.
t. Debtor(s3 (Last Name First) and Address • 2. Seturod Party end Address * Fw FilingOfficerlDste, Time, Number,andFiting
Offite)
:I~, Jos~~~n, : oll,Y
~ .'23 J? ~ a:. iar -~l•~ i.
_ L :'~.;:r~e~ rla, 33:t:~ u •
4. This financinp staternent coversthe following types(or itertu) of property: (Check Dox which applies)
AA oj the household furniturc and jurnithin~ eltcnica( and aas appfia~cr; including tetrvision
~ sett phono~apl~.t and ncord ployer.f. rcfrigerotor; etc , and othtr pe~sonnl propt?ty now o?vned
or he?eajte~ acquixd in rtplacement tht~tojand now or hrnajter Jocat~d ot tht rcsidenct oj th~
Debtors at the addnu ~i~•en cbove in Box l.
5~ Assigneels) of Secured Party and Addresslesl
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! Check if true[~x The stamps required by Chapte~ 201, F.S. have been placed on the promiuo?y instrument
~ secured hereby, and will be placed on any additionsl and similar instrument that may be so se:ured. _
; I:acumentury stainps attached to ortalna/ notr and cunce!!ed
~ Th ~s statement is filed without the Dsbto~ signature to perfoct a security interest in collateral. (Check Qx if so)
F ? Already wbject to a security interost in another jurisdiction when it was brought into this state.
€ ? which is proceeds of the original collateral desc~ibed above in which a security interat was perfectod:
~ Check[~if covered• x~ Proceeds of Collateral are also cavered.OProducu of Collateral are also covered. Na of additional Sheets praeoted:
~ F i led with: C1e~k oj the Cinutt Court oj County, Florfda
~ Secured Pxty * . , .
~ ~c~ . . . . ;
~ . . : .>.t , . .i..~:
~ ~ Debt~ ~ ~Y
~ ~ . ~ ' .......`7..~..~•/'L.-:~ BY ...........f...~.~sl~i:...~.........
~ . . ~ .
~ Debtor Manager
~ STANDARD FORM - FORM UCC•1
~ * Type jvf! and con?ptete corporatt noma ;
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