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~ ffiis fiNANC1i1C SiAiF11OtT is p~aeMed to a fiGn~ offioer far ~ilint P~rwud to tA3 UmMrm Commud~i Oode: 3. MnoM~r d~te fd a~ry):
~ 1. Debtor(s) (tast Name First) sad sddress(a) Z S~au~d Psrq(ia) a~d sddrsss(~ For Filing OKroer (Drte. Tia~. Nua~ba.
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~ 4. Teis r~naAs ~ oow~s m. touo~~.~ +yva .aa~a ~ea~s a v~v~nr: ~v~
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(a) H daaiped. Mda Yehid~ ss tollo~x
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. To~.ther wita sa rres„ satt«ie~, Raaios. Htaters. EwiPe~t .ne Aoo.s~oriu .ow « INn,tEu a~e m.rdo: ~ts^
~ , (b) Olf d?ecked st bft, all hous~hofd yood~. fumiture, appliances, snd conwrt~er goods of wery kind and ~~~~,p
~ desviPtion owned at the ume of the losn seeured hereby, or at tl~e time of anY rofinanos or renewM there- ~w t o~ni
of, w cash advanoed under dn loan aprssmsnt secured herebV. and located sbait the premisss st the ~ v~.:~~
Oebtor's residenoe (unleas od~erwise ~tated) or at any other location to which d+~ poo~ msY be moaed. es~~
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- This staten~a~t is fiied wiWo~t tNt d~bta's to P~~ ! s~! i~4te~t iu ~al. (d~ed~ ~ N~o) + ~ 1i
O ~irad~? subjeet to s searihr iataest in anotArr jurisdictio~_ whe~ ~t was lXoutht inb tbis sfate.
p wfiicA a praa0: ot tM aitia~i coUstu~l desuibcd sbow in wwich s s~curit~l ~ wss pafeded: - ;~t.LG~ ~
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l~Ck ~ it oore~ed= O Proaeds o1 Coustersi sn ~Iso ooyerN. O Produ~ts d~OHabrai are sbo oorer~. No addidon~ Sh~s pr~a~/=
' FUiURE ADYAlICES ARE ALSO COYEAED. FdN wdA:
THE SfqlRITY INiERE9T NfILL SECURE FUTUNE OR df11ER tN0E6iEDNESS•
~v'; RMiNAI10lf STATEMENT: TWs SWNeent d`terml~tioe M uisada~ is Waa~ad to a iili~ OHiar tar flliet OYrswM to ihe llaiWna Caam~ra~l Codt:
Tt» S~aKed Psrtf artifia i~st tlw SeaKQd Psrtr ao lo~ dsia~s a scauit~r i~atte~est w~der the fiweaa[ statan~t be+nn[ the fiN num6a showa abore.
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` (3) FlLIN6 OFFlCER - ACKNOWLED&MENT A ~ s«..+ an? « ~w» ~ u~w» s~..+.~ ~
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