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HomeMy WebLinkAbout0550 ~ ~ ~ ~ ~ ~ . ~ ~ iHlS i1NANCINCs STATEMEIii is pres~nbd ~o o fili^Y offiic~ fw filiig pwtwet b tM Uniform Cw~wwerod Code: MoMiy dote li( wryl~ ~ t. O~bb(sl (tast Mowie First) ond addr~u(~s3 I~~f 2. S~wred ?a?h("»s) and addr~ss(~s) Fa Fruq OfFic~r (Doa. Tinr. Nuw~b~r. wd fiG~q Off:c~i Patt~aon, ~ug~n & Orai~ 3-`~`1 gY~~ ~at~o fitfn ~t: e~cv3DE0 904 X 17th Star~et . 3~16 S. Fed~al SighWa,y n sT.~u~~~ ~~;;~Tr fu, ~ Ft. Pi~o~, Flarida 33+1?SO Ft. Pi~rae, Fl~ida 33450 ci ~ ~~~C ~ s T~DURT ~ AfCG-'^` ~r: :~r~ ~ a_ il,is Rnoncin9 swh~nt cw~ra M~e folbwing yp~s (w ituws) or P~oVKh= wfr i0 JO 38 AN'~~ Z; All of t6• consuiw~r yoods nor (ocot~d ie or about Ih~ prMnis~s constitvtinp th~ debrors' resid~ncs ot their addr~ss obor~ s~t Fortl+ o~ ot ony otl+~~ oddr~ss to which th~ san~ w+ay b~ ~eaw.ed o~d anr p~ope~+y I~st~d b~b... 3. Assiqrr~(s) of Sew~~d ?o~b w~d Addr~ss{~s) ~ Th~ folio.~~ry o.op~•ti: ~~~Q~ v ~ 2~8'7894 ~ z; _ ~ - ~ 6. rcv~d od~l''il. .~or rY^eM•;J aiwas Wb.. aqtis Aer ~M sbros r~?~nd 61r O~e~G+M ~01. Flordo SwNNt ~1 s7. bw be~ ~ ~ o`«ed w ~M voms~ory .•.s~w~w+s ~cwd M~~br. e~d w.Y b~ v4nd e~ oi7 ad6~.owe1 ond a.w`Is ~wP~wrM tM~ woI b~ so wcrM! ~ _ i ~ mtensf in collotetal. 1~heck ~ if so) v~ Tf~s sbtem~l is fil~d w~tl+oV~ Mw A~bm? s u9~°~e M prfM a t~twify ~ ~ At~~y w~ct fo o xcwity inqr~sf i~ onotl+N jwisdicfio~ wh~~ if wos brovqht info Ihis sbN. w•hich is poceeds of H» oripinol cdberrol desvib~d abore in whid+ o s~cwilp iMer~st wos penc~ted: ~ - Ctie;k ~ if cwrred: ~?roc~ds of CdbMOI or~ o1w cover~d. ~?roducts of Cdiau~ol on alw cwsr~d. No of odditipwl SMets pr~sented: --fJed .riM: Q~ ~ {iii Wi~V ~ 3 ~ : ~ . C/V ~ V~Y~i-~ , ~dYi~ ~ ~ T i a~_ f ~ L .t ' w:_ Siqxo N of D~bta(s~ ynotw~fs) of Sewred ?orhiies) z STANDARC fORM - FORM UCC 60~ ~ ' i~ 3'.. i^:::• r n_ %t~.. ~ APP~ M Richo~d (Dick) Stone. S~cretary of Sfo~e. S~a~e of Flo.cdo . . _ _ ~Y , - _ . - - - - - ~ ~ ~ - . . _ . . _