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THIS iIN/WCING STATEMENT is pr~»n~ed a o f+Gwp offic~r fw filiny pwwont b Nr Unifwrw Coereerdol Cod~: ~~ib dok °^1~): ~
~ t. Debforis) (lasf Nonr Firs11 oed oddr~u(es1 1'~7 . Searr~d ~wfyfi~s) ond eddr~sa(~s1 fw f:tiwq OI£w~? (Oet~. Tiw~. llYwber, ad R6nq Offia) ¢
C~DS~sl FSIIaIICe CO FILEO ati[ -~EC~~DEO ~
~j~~1 P• ~lI V/ DA TpOTB~Cd ST LUGiE L,:UNTT FLA_
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1,yp8 Nyaaing Avenu~ 3018 . Fede~at Highwa`y ci E~~ c: ; c w r couR ;
Ft . Piea~ce, Florida 33450 F'C. Pierce~ Florida 33450 ~ n F ~ v~ ~ :
4 ih~s f•nonc~uy sbfe~nf coven Ihr fdbv+inq hpes Zor ilea~s) o? poperh: ~7{I{t f~ IZ 34 P ' I~ iw~ ~
GONSiA~ C~JODS LIST~ Oai 3CHF.DUI.S A BEARING E~T DAT$ HFRSHITH i~~~ 15
S. Assiynee(s) of Sewred ~ory ond Addrru(~s)
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6. e:ec~...d m~+r~.a3. w*cy ri^~nn•'~` oov.e's beb.. ?ow> no~ +M •+w~O+ •~v-~•.d Af O+opK IOt. flr.do Ymv4a. •1 anf. M.. leen ~
_'~r-ed c^ .~e va~.~v~ .ns~..wr~r~ ie:~wsd M~4r. o-d ~,t1 b~ dxd w w/ a1J*.ord ad rwior .ena~wui+'hol ~nos M w wcwed. S
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1~~s sblemenf is Iiled withwr N~e debfoi s s:qno?we b perfetl a secwity inlerest in colbterol. (Check f~ if wj
A~rrody wbject to o secvriy interest in o~olher 'ryri~ction wAen if wes bouyhl into rh~s sta4. ~
wAicF~ is proteeds of 1M wi9i~o1 cdbterol dtWibed obove i~ wh~cF~ o secvr:yr i~krtst wos perfecled:
~~,eck i{ co.er~d: ?roc~eds of Cdbrerol ore olw co~r~red troducts of Coliokrol me olso cwered. No. of odditionol SF~eets pr~sented
F,~.d alsrk of cirauit ao~t
Gene~cal ~~inanae Cos~paaration
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STANDAR FORM - FORM UCC-1 / ~
Approvtd bp Riehord (Did) Sbn~. Stc.ebry oi Seet•. S~oh ol Fio.~~a
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