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TMtS fiNANC~NCt STATfMEI'1T is pHf~wNd b o fiirq OH~icv fOr h1iaY PKfuouf b/he UwifOnn Conrw~rtial COdl: Molwiyr dob (if onpl: i
1. Debbrfs) (tmt Na~ Frsf) o~d addreia(~~ s i S~wred ?erb('rs) awd oddr~a(~s) Fer Fi6wp Offiar (Do1~. Tw, Nu~~. awd Filiig Offia) i
Douglas, Carl & Natieaa 9 a~/~ General FinBace Corporatiau ~~~E~urD REC~R Ep
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j~19Bth~be6 RpBd ~1g S. Fede~al High~y ROOER PQtTRAa Ul.
Fort Pieacce, FL ;~450 Ft. Piezce~ rlorida 33LF~ RECORD YfR'FIEp C~~T ;
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n+:. rw~anaw sak.me co...i r. wtlo-Ma hv.. co. :u.~.) a. wow.~r:
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~ All of ?h~ consu~e~ yoods no.r bcet~d in w ebout tF~~ p~a~is~s constitutin~ ~h~ debtors' r~sid«~c~ at
th~ir ed~~ss abor~ s.~ fo.rl~ o~ m o~y o~•r address w which tM sae~ wor b~ resor~d md my prop~rtr
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3. Assiqne~(s) of S~arr~d ~ory and Addneu(es)
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~ 6. rtie wau.e nsrytat. .p~aa..!al ac~o~on n.b~. rsrs ws rr ne.~o. ~.aw~d rr Oror. IOt, ib.~ds S~w~.s. H e~, ~o.~ w«.
ob-d a M~e aars+ory .~s..wrw~ sowM Mnbr. ati ~+i W dead aw ewf oddworl and s+r1r w~rw~rN ~Mt wo1 0~ ~e ~cr~d
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TAit s~s~ew~eM is f.ltd ~rifhw~ N~t d~blors signohn~ b PK~* e~b wM~st in aoNoMrol. tCh~c1~ ~ if w) 4
Alreody subjett b o stcwil? iMa+est iw m~oN~N j~R~sdMien wAMn i~ wns btou~M iMO Nlis t1oh. ~
whitA is pewds d Mr arpiwsl colbterd d~sa~ed abow i~ whetA o secwiy iMerest ~ros p~rfected: . ~
~ LMck if ce`ered: ~?roneds of CotloMOi an olso oswe~d. ~ hoducls of CdioMal u~ alw wwr~d. Nc of oddirionol Sheeb pnstMed: 's
F.~ clea~k of circuit cowct ~
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STANDARD FORM - FORM UC~-1,
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