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STATE OF FLORIDA
UNIFORM COMMERCIAL CODE - FINANCING STATEMENT - FORM UCC - 1
THIS FINANCING STATEMENT is prosented to a filin9 off'~cer for filinp purwant to th6 Uniform Commercial Code: 3.
t. Debtorls) (Last Name First! and Addross 2. Secured Party and Addreu * For Filing OfficerlDate, Time, Number,and Filing
Otfice)
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d. Th is finencing stetement covers the totlowing typeslor items) of property: (Check box which applte.rJ
~ Al/ oj the household jumiturc and jurnishirs~ efectrical and aos applianc~; including televislon
~ srt; phonoarnphs a~ nco~d pluye~ njrigeratont e~c., and othtr pe~soral p~opr~ty now owned
or he~rojte~ acquircd in nplocemrnt ther~ojcnd now o~ hcrcajter located ot rht nsidence o~ the
De6tors ut the oddnss ~iven obo?~c in Box 1.
- 5~ Assigneels) of Secured Party a~d Addreules)
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t o. Checlc if true x[~ The stamps required by Chapter Z01, FS. have been placed on the prom'~ssory instrume~
f secured hereby, and will be plsced on any sdditio~al snd similar instrument that may be so secured.
~ Documentary stamps attached to ortaina/ rtotc and eancefled
t This statement is filed without the Debtors' signaturo to perfect a security interest in collateral. (Check ~x if so)
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t ? Alrerdy wbject to a security interest i~ another jurisdiction when it was btouqht into this state.
s ? which is procceds of the ori9inal collatersl desc~ibed above in which a sacurity interest was perfected:
~ CheckC1if covered• Q Procceds of Collateral are also covered.[]Producu of CoUateral are also covered. Na of additioosl Sheeu presentod: _
~ F iled with: Clerk of tht Crrcuit Court oj _ County, Flo?idu
~ Secured Party *
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~ Debtor , ~;'s'~
~ ~3.z.:..,;.~....~.....::: :-r..........:'.~.:.~c.~~:1~-............ BY .
~ ~ ~tOf STANDARD FORM - FORM UCC-1
~ * rypt JE~1J and complere corporote ncme.
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