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E I ~ i ~ ~ ~ e ~ . ~ THIS FINMICMIG STAifMB~lT is P~~ b o f~t~g off.cer iw fil~g p~wsuorr b ~he Unii~w~n Canne~cwl Codr= 3. Mat~witp doM (if any:) ~ 1. De6~ts) tlmt Non+e Firstl and oddrenks) 2. SeaKd Rorryi:as) ond oddressksl , Fa FJ~ny Offiaer (Dofe. Tims. Nurnber. - ond Fl~ny OFfios) lrloulard, Chest~r ~arbai'a ~agle Finance ~o--p o~' `r"P ; 32~2 Anderson Dr. 2G~57 5.~~ H~y FL. Pi~ree, F~a. ;3it5~ Ft. Pierce, :la. 331t50 ~~o ~ 4. This fMlaf1ci119 ffo~e~l~M1f ODre~s the iOllO~r%1~ hPl~ ~Or ill~K~ Of p~O~1Y= i ~ i As listed on scr.edule "A° securi :.y list dated 8-2-71~ ~ ~ S. Assiqr~eels) of Secvrod Pb.ty ond Addr.sslw) t ~ ~ ~ ~ e. n,~ secvr.a vaM:~. ~~9'~~ ~s bdor.. s~a e+or +n~ ib.nv: .equiroa M c~ t ~ Hordo SbMes. ~f u^Y, hvoe been placed m tl+e pron+~sswll hstn~ments setueed he«by, dd will be ~ ~ ploced on airy odd~tarwl and s~awlar ~nstnwewit Nwr n+op be os soaned. j ~ This stotemcm is filed ~riNwu~ ~he de6Mx-s s~q~whwe to perfect o se~uify irreresr x~ colbterol. (Check ~ if so) O/Weody +~ibied ~o o secv~M ~+eRSt ~e+ oiwrtw ryredctan Mrlien ie ~ras broughr ya~o ~h~s sw~e- ~ ['j 1M~id~ is pioceeds of the ay+~ol mlfoee.d deso.bed obore in wh~d+ a secw~ry waKest wos perfMed: _ C,hedc ~ if ao~re+ed: ? P~oceeds o~ Cotlaterol ore olso cwered. ~ Nroducn of Colbreml ore olso corered. No. 04 Additionol Sheefs p~esented: FiMd willh ~ ^ gcex ~ac~ 26g$ ~ , . r FA•iZ. ?`::~t~i ,.v:~~ ,r1~ F ~ ~ ~ _ ~ ` I ' ~ ~ , - ar_ ~ti Gt--` sr- ' " ` ~ Si~a~wrNs) d Oebats) S+gnohwels) of Ponyl~esl ; STANDARD FORM - fORM lKG ~ ~ r~ r F;;•. ~~1; r;' r. A_1 ~i?abel:cal ~o~d M~fw.d ID~1 s+«+e. s~eo~ro~y of Sro~e. State of Florido ~ , , ~S7-C' o~c. ~oEws No. ~ e~q _ - - - , - - ~ _ . ~ ~