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Boi 2~L-I Ed May '70
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STA7E OF FLORIDA
UNIFORM COMMERCIAI CODE - FINANCING STATEMENT - FORM UCC - 1
TNIS FINANCING STATEMENT is presented to a filiny officer for filiny pu?want to the Unifarm Commerciai Code: 3.
1. Debtorls) (Last Name First) and Address 2. Secured Party and Address * For Filing OHicer(Date, Time, Number,~dFiling
Office)
~ AY 0 DAVEY ~FNFR ! C! AL F 1 ~1ANCF t'!~.
?^~4 S 87~1 ST 1141 S FFD NYW.
~T pIERCE,FL,3345~ FT PIF~('F,FL,3'~4~n -
Tfiis financing statement Coven the totlowing types lor items) of property: (Check box which applies)
Al! oj the houstho/d jurnitun and jurnishing; efechical o»d gar opplfanct; including telerisfon
~ set; phonogmphs and neord playe~ rcjrigeroto~ etc , and othtr pt~sonof prope~ry noN ownrd
o~ heirojter acquired in r~ptoccment thereojaied rtow o~ hereaJte~ lorat~d at the ~esidenc~ oj the
Dtbton ai ~he oddress Ri?•en ubvvr In Bos I.
~ 5. Assigneels) of Secured Party and Addressles)
o. Check if true~x The stamps required by Chapter 201, F.S. have been placed on the promissory instrument ~
secured hereby, and will be placed on any additional and similar instrument that may be so secured.
I)ocurr.rntary stamps artached to original Rote and canre/kd
Thi> statameni ~s filed without the Qebtors' signature to perfect a security interest in collaterat. (Check ~x if so)
? t1lr~ady wbject to a security interest in another jurisdiction when it wai brought into this State. -
? which is proceeds of the originat collateral described above in which a security interest was perfected:
Ci,eck~if covered: Proceeds of Collateral are also covered.OProducts of Collateral are also covered N0. of additional Sheets presented:
F iled with: Clerk oj the Circuit Cou~t oj County, hTo~lda
Secured Part
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Debtor ~ Manager
STAP~DARD FORM F('jRM UCC-1 -
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