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STATE OF FLORIDA
UNIFORM COMMERCIAL CODE - FINANCING STATEMENT - FORM UCC - 1
T H!S FINANCING STATEMEIVT +s presentad to s filiny officer for filinp pursuant to the Uniform Commercial Code: 3.
t. Debtoris) (Last Name First) and Addreu 2. Secured Party srxl Addrets * Fo? Filiny OfficerlDate,Time, Number,andFili~g
Office)
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This finanting steterrxnt ooversthe fOliowi~ typeslot itertu) Of property: (Chttk box which applltsf
AU oj the houschold furnUurc and furnisAin~ ~JecMcaJ and gns apPliance; fncluding televicion
~ sers, phonoaraphs and record playerr. njrigeroton~ etc., and othe~ pe~sonal property now owned
or hereajter aequtnd in nplacen+ent tht~eojand now o~ hereejter located at ~he nsidence oJ ih~
Debtan at the addnts xi?Yn above In Box l.
5~ Assigneels) of Secured Party end Addressles)
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j Check if true(] The stamps required by Chapter 201, F.S. hsve been placed on the Promissory instruments
j se:.ured hereby, and wilt be plaad on any rdJitional and similar insuument that may be so sacured
I).~xumenrary stamps attached to oria7nal nott and connlled.
6 ~ s staternent is filed without tbe Debtod siqnaturo to perfeet s security interest in collsteral. (Check Qx if so1
~ [j Already wbject to a security intenst in anothe? jurisdicYwn when it was brouyht into this stat~
rj which is proceeds of the oriqinsl collateral desc~ibed abwe in which s sacurity interest wss perfxted:
~ -:e :k ~~f covared: [1 ProcNdt of CollatKd an +~so covered•QProduc of Colla eral are also cavered N0. of addiUOnal Sheeu presented:
r;1ed with: Cl k oj tht Ctrr.vit Court oj .GLl~C~ Counry, F7ortda
Setured Psrty * .
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' Debtor STANDARD FORM - FORM UCC-1 Ma~r
* 7~pt full and tompfete eorporatt namu
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