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Bo~ 21L-1 Ed Moy '70
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STATE OF FLORIDA
UNIFORM COMMERCIAL CODE - FINANCING STATEMENT - FORM UCC - 1
7HIS FINANCING STATEMENT is presented to a filiny off'~cer for filinp pursuant to the Uniform Commercial Cods: 3
1. Debtorls) (Last Nama First) and Addross 2. Securod PartY sed ~?ddreu * For Filinp Officer(Oste, Time, Number.andFiling
Office)
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4. This financing staierr~t covers the foilowing typeslor iterra) of property: (Check box whtch appifes)
A1! oj the household jurnitun and jurnishi~ elecMceJ and gos apptiance.x includina ule.ision
~ s~et; phonoanapht and ncoid playesrr nj~iaeroto~ etG, and other personal property now owned
or henajter ocquiird tn nplacement the~roJand now o~ he~raJtei located at the nsidence oj the
Debton at the addnss ~tiven above fn Box 1.
5~ Assignee(s) of Secured Party and Address(es)
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6. Chedc if true[~x The startips required by Chapter 201, F.S. havs been plated on the promiswry ir?strumet~
secured hereby, and will be Placed on anY additionsl and similar instrument that rt~ay bs so secured.
Documentary ttanp.r attaehed to oriaLu/ note med c~nctUtd
This statement is filed without ths Debtors' signaturo to perfsct a security interest in collatersl. (Chadc.nx if wl
'i Alrosdy wbject to a secu~ity inurest in another jurisdiction when it wss broupht into this ststa
! ? which is prooeeds of the ori~inal oollateral described above in nfiich s security interest was perfected:
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~ Check~if caversd• x(] Proceeds of Collsteral are also cwerod.[]Products of Collateral are slso oovered Na of additwnd Sheeu presented:
C Filed with: Ckrk of the GY~neitCaert oj County, Florida
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~ STANDARD FORM - FORM UCC-1
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