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Tr+iS FINqPICING $TATEMB~lT ~s pnesented b a filiny officer for filiny pw~uunt b ~he W+;io~n Cannerc;ol Code: 3. Moturity doro (if any:)
? ~ Deb*or(ss Itost Non+e F~nt) ond oddrcss~esl 2. Senx~d Port~r(iesl ~d oddres~ksl For Filinp Officer (Dote. Twne, Nunibs~,
3 - • i - ~ ? ~ • - . , and Filirg Offiae~
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: All hausehoad ~oo~ furn; shinPS at the abovd addreas.
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- 5 Thr secund porty~sl. wFase siynatvae~s) oppears bebw, stotes Mwt N+e sbmps iequired by Chopfer 201,
i Flw~do Siotwes, if ony, hove beer~ ploced an rhe prom~ssory ~nstrumenn secwcd hercby. ond will be
p!«ed on ony oddihonol ond s~mitar instnwnn~t Mot mor be os secusd.
s rn~s statement is I~kd wi~hovr ~he Acbbr's sgrwt~xe to perk~ct o sacuity ir?reresr in colforewL ~Chsdc ~ if so)
Alreody subject )O a secur~ty interesf irf anOthlr 'ryrisdic7qn whe~l if was brOVghT inM ihif stob.
F , Whicfi is proceeds of the wginal colloterol descrlbed obwe in whicf~ o secwity inmest was pertxted:
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C~eck ~ if covered: ? Proceeds of Cdlote~al orc also coreitd. ? Products of Cdbterol arc olso cwered. No. of Addit~orwl SFxe1s presented:
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- S+gnmurNsl Oebalsl Si9noh,.Ns) of Sxued Porty(ies)
STANUARD FORM - FO,[2M UCC-1
r!~.^; ~f~~er ~^r•y .~`!rhabeticaE App?oved by Ricfiord (O~ck~ Srone, Secrerary of Srote, Srore of flor;do
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