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~ STATE OF FLORIDA
UNIFORM COMMERCIAL CODE - FiNANCING STATEMENT - FORM UCC- 1
THIS FINANCING STATEMENT is p~esented to a filing officer for filiry pursuant to the Uniform Commercial Code: 3.
t. Debtorls) (Last Name First) and Address 2. Secured Party and Address * Fw Filing OfficerlDate, Time, Number,and Filing
Office)
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a. This financing staternent covers the foltowing typeslor items) of property: {Check boa which applresJ
! AU oj rhe household jumiturc and furnishin~ eltctrical und gas appliance; including television
~ set; phonogrophs and rrcord playtrt njriatwton. ttc., nnd orher personal property now owned
~.-10~ hercajter acquircd in rcplacement tl~enojand now or hereajter locoted at the nside:+ce oj tl+e
Debtors cr the cddrcts Riven abovr in Box l.
5~ Assigneefs) of Secured Party and Addressles) -
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' o. Check if true0 The stamps required by Chapte? Z01, F.S. have been placed on tAe promissory instruments
j secured htreby, and will b~ Placed on any sdditional and similar instrument that may be so secured.
! Docummtary sramps attoched to orlgtnal nott and cancdled
~ This statement is fi~d vrithout the Debtors signature to perfect a security interest in collateral. (Check Q if so)
Already wbject to a sscurity interest in another jurisdiction when it was brought into this state.
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~ ? which is proceeds of the origi~sl collateral described above in which a security intertst was perfected:
~ Check[lif covered• Procaeds of Collsteral are Blso covered.QProducts of CoUateral are atso covered. Na of addiYwnat Sheets prese~ted:
F~!ed with: Clerk oj the CircuttCourt oj Couny, F?ortda
~ ~ Secured Party *
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~ Debtor STANUARD FORM - FORM UCC-1 Manager
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