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~ FINANCihY'i STATEMENT is prexnfed to o fiGng officer for ftllnq pursuant to the l:n~icrm Corrme+c~nl Coda: 3. Matvriy dore (if any):
1 2. Secwed Porty(iaa) arx! address:es) Fw Filing Officer (~ate. Time. Numbet, ond Filinp Offi:el '
~ . ~rbforis) (Lost Name f+nt) a~d acidreutes) ^
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~ - - _ _ z•...; ~ ~ c,: . . ~i~+:. ~ . ~ . - _ . ~ RECOR~ YERRCWT C41MT
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~ a Tn~s f.nonc~r:q stafement ccvers the foliowing types (or itzrns? of p~erly:
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~ AN of tha hovsehold goods ~c,-w a hereaftcv bcoted at debtor's res~dence oddress set forth above. (
`ty, i
j S. Ass:gnee(s) of Secured Party c~d Address(es)
_ ` v ~:iner prcp°rCy deW~bc~ o' (Uem) ~;~9353 k
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= 5 C1:eck if tr~a ~ ihe stwr.ps requ:red bY ~aPtef 201. F.S. Fw~e been placed c~ the p~omissory instrurnerts sec~red ~ .
r,Ereby, w+d w~tl be p{aced ~ ony oddit~onol and similar inst.ument that may be so secvred. '
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Th~s state~neM is f~ied w~ti~cvt ths debtoi s;iqnatwe to perfect a sec~rity interest in cd{arerot. (Checlc 0 if so)
5'-; ;_J Already s~~bl~ !o a xcurity iotr.est in another j~rlsd~cnoo when it wos brouqht inro ihis s:ate.
U which ~s poceeds of tns w:g~+wt collateral dewibed obove in wh~cfi a secur~ty ente~est wos perfected:
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;~zi ~eck if covered: Proceeds of Col{ote-~al are also covered. ~ Products of Gollateral oro olso covered. No. of oddetionol Sheets pese~ted:
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~u=~'z Piled with: jl' i C." . i~ ' L
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$pnot s) of Debtor(s) Siynat~re(s) of $ecu~ed PartyGes)
-r r;~;~g OfPKQr coor - ~ ~~b•h~~~ STANDARD FORM - FORM UCC-1 - -
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