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` THIS FINANCING 51ATENIB~R is pr~seMed to o filinp offiaer fw filinp purwaN to tM Ut~i~ Conr*riciol Godh 3. MohR~h dot~ (if orry~l -
1- Debwrlsl (lost Nomt Fiat) and oddreules! 2. Sscwd Porh~lNS) ard oddnss{~s) . fw filinp OFfioer IOote. Tinw, NNnb~r,
~ GLE FINANCE °"d Fi'"°
'I~cker, Jessie .O. BOX 3265
2703 Hills Ct. ~457 S. FEDERAL HWY•)
Ft. Pieroe, Fla. 3 3L5~ . PIERCE, I~i..OFjDA 334~0
This tinanNnp s~aun~nl aove+s M+e idlo+rirg ~rP~ (or i+emsl of propKty: ~A7~GA17~~a~
As listed on schedule "A" security list dated 9-23-?1~
~ s- M.+pn»ts) or s.cvr.a p'o.t~?.d ~aa~1..)
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e. The ~cvr+d porryl:l. wlwae s~9rwh+rels) oPP~an btbw, storts Nwt the stomps rquitid bY Clwpter 201.
~ Flotido StotuMS. if anr. hove been plocsd on the p~omistory instrunenri ~cwed herab~r, ord will b~
~ ploced On ony oddifionol ond similor instrunNrM fhot mOr 60 oi s~oiRed.
This stosemMt is fikd wiNw~A the debtot's sip~wMe b per/eci a tecwity i~st in cdla~le~ol. (CI»tlt ~ if so)
~ p M~ody s~ibj~d ro a ~scv~ty interes+ in onoN~ jurisd~ctan wMn R was brouphr ~roo this sto~e.
? Whid~ a qowds of the o~ginol oolbte~ol described obw~ in whid~ a seaxity inmest wos puf~ctd:
Check ~ if core~ed: ? Proceeds of Cdbterol are olso oorered. ? Products of Cdlotaol ore olw corered. No. of Additiawl SMs1s p~esentd:
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STANDARD fORM . - FORNTt1CC-1
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.~"'.J~ 6' - p(EC_ IOEAS NO. 1679
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