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Bo~ 24i-•I Ed Ja~s '67
. ~8'7~~9.
STATE OF FLORI~A
UNIFORM COMMERCIAL CODE _ FINANCiNG STATEMENT - FORM UCC - 1
THIS FINANCING STATEMENj ~s pr~s~nt~d to o(iiiny o(fie~r fo~ (ilinp pursvont to theUniFo~+n Commwciol Cod~: t 3-
1. D~bta(s) (Lost NoaNFirstjondAddress • 2. Secur~d Pwrp ond Addr~ss~' ForFilirqOffic~r(Oot~,Tim~,Numb~r,o~dFilinp
Of(ie~)
'::::1: 8y,bi~ Laura _ : :~~~.,~2~ C-.^,3i•~~ .
?~~'1 ..:J%t0!1 i?Yv' ~~'.1~ .:i~~ r 3 1 -j^T',{
: ~rt : iar~~a, :'2a. ~ .o^+ °'_;:r~~~, :la.
4 7his financiny stat~nf covws th~ followirg typ~s (or it~ms) of p~opNtp:(Cbeck box u~6icb apQliesl
~4l/ o/ tbe bousebold goods now owned or bereaJte~ ucqui~ed in sepluccment tbereo/ and rwu~ or
erea/ter located a~ tbe Debtors' place o/ residence at address given above +n Box I-
S. Assiyn~~(s)ofSecw~dPo~fyandAddr~ss(~s)
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Ths sta s~~ ir~d by ~~t~r201, F.S.hov~bs~n pioc~d on th~ promiuory instrum~nts`
6. Ch~dc if tru~ ~ ~P 9~ !
secur~d hw~?y, ond will b~ Ploc~d on ony odditianol ond similor instru~t that moy b~ s~ sKUr~d. 1
' Documentary stamps oftacbed lo, origino/ rwle and carrcelled
i Thi s stot~m~nt is fil~d without th~ D~btors' siynotwo to pKf~et o s~curity iot~r~sf in collofrol. (Check L is w)
I r Alr~ody subj~ ~a o s~euriryr intN~st in onoth~r jurisdiction w6~n it was bwu9M into this stat~.
~ ~ which is proc~eds of fM oriyinal collat~rol d~sc~ib~d above in which a s~curity ~nNrfst wos pwftct~d:
~ C heck~ if co~~r~d: ~ Proc«ds of Collat~rol an olso covn~d. CProdu s oF Colloterol or~ also cov~r~d. No. of odditionot Sh~~tsprssent~d:
a _
Piied witk Clerk o/ (be Ctscuet Cou~t o/ • ~ Couoty. Fto'tda'
~ S~cwed rtr~' `
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t_=y~ _ MaooqN
uswor
= STANDARD FORM FORM UCC-1
Type /ul/ and complete cosposale name. i
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