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~ THIS FINANCING STAifMHJf is presented to a filinp oHicer (ot filin~ purwnM b tlte I~ni~wm Conrnerciol Code: ~ 3. Malurity dole (if ory/:) ~ :
t. Debtor(si (last Nane First) ond addressla) 2. Secwed Portylies) ond oddreulesi fw f~lioq OHioer (Qote. Time. Nunber.
~ ~ ard Filinp Offia)
~ellamy, Adenia Eagle rin-:noe ~oro of ~'P
2,'1G Matanzas Av. 20~7 S.Fed H~ry `
~ t. Pierce, ~'la. ,~It50 Ft. Pieres, ?la. ??1~50
2~.9~9
A. ihis finoncirg sta~emenl corers tl+e followin9 tYPes (or itemsl of p~opeAy:
As listed oa schedule "A" security list dated 8-6-?!t -
~ S. Assiqneels) of Sscured Portp and Adde~lw)
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3
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SA
~ 6- The secued portylsl, wlwse siqe+utwNs) oppeon below, stwes Nwt the samps rpuirod by Chopaer 201, -
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Flwido Stosvles, if any, F~ave been ploced on the prom~ssaY ~nstnwnents secvred hercby, ond will be
~ Qloced on a~y additionol ond simlbr instrumerN thot rtwy be os secwed.
~ This stotamenf is filed widwu~ the debtor's s~9^ohxe ~o P~AM o sec~+"N interest in cdbteral_ (Chedc ~ if so) :
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? Alreodr xrbject ~o~o secwir~ inrerest in o~wN~cr jwisdiction when it wos bra+9ht inro this stote. ,
[_J Whkh is p~oceeds of the orginol eolloterol described obove in which a sen+rity interest wos perfeded: r
Check ~ if cwe~ed: ? Proceeds of Cdlaterol orc olso covered. ? Products of Cdbterol arc olso cove~ed. No. of Additiaal SFxeh presented: ~
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Filld with:
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~ ~ " A6f ~_,I,':; rI':S :'CE CORP
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S~qnot~Nsl o( Debor{s) SiQnoh~e(s) of Portylies) a
~ STANDARD FORM - FORN1 UCC-1 ~
~a~ R~clwrd (D~ckl Stone. Secretory of Sfore, Stofe of Fbr:do
F;!'~:, ~f~~cer C~ry. Aiphabe~iea{ ~?vw~ br
j.l 7 EXEC. IOEAS NO. 1679
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