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~ . ~ ~ . 1 . ~ ~ ! ~ i i - - TH15 NNANUNG STATEMBJT is P~ b o fitinp ot~ic~? for filirg puravaM b 1M U~iioan Cort~nna~cial 3. Mohw~tp date (if ZZ~ 9 1. D~btods) Mst Nan~ Fint) ond odd~ssla) W~s1 Fa Filinp Offioer tDot~e. Tia~. NuenbK. ~O ond Flir~p Offio~) Hook~r~ Jack R. & Ru~~ B~X 32G5 L~~wY'~~ 0 3~.t1 su~emit - . (2057 S. FEDERA _ ~'t. Pierce, Fla. 450 . PIERCE, T~I.aRiDA 3345 ~aSa~~ ihia financMg stolae~w~t aov..s tM tollowirw hP~s (a ~^s) "f p^Op~'1y' As listed on schedule "A" security list dated 11-5-?4 • s. 11~;qrwbl of s«w.a P+~? and ~?aansN.d t 6. TM rax~d Ponlrlil. s'~^O~°~s1 °P~°n bdow. stas+s Aat the sta~s nquind bY uwp~s~ ~0~• Horido Sbtula, if an~?. hovs bMn pload m M» Pramssory imtnrn»r?b s~cverd l~enby. ond witl be p{uad an on~r odditionol ond similw u+stnnnNK ~hot moy b~ os s~a+nd. . 11,is stot~na~ ~ FMd wiM,ow the deba's sgnoh~et b PKfed °+~n+?~h i~a~sf in oollonrol. (CJ»cic ~ if sol ?~+~r ~,~t ~ a s~cw~h i~ in anorlwt lu~isd.Ctian wFrn a wos brou~l+t imo ~ia sto~r. Q NM1~ich is powds of tM orginol adlorud desaibsd obow in which o ~sawity inN~est wos parf~ct~d= Chsdc ~ if aovend: ? Procwds of Co11oMO1 ae olso oove~d. ? Products of Gdto~erol a~ dso carered. No. of Additionol Sl+ests p~seMd: Rld ~rillh - € EAGIE F'II~ANCE CORP • _ ~ ~t/ ~ S;qnoluntsl of D~6ror1sl 5gnohrRl~) of Po~ STANOARD FORM - fORM l1CG~ !'~GF ( f) Fi(ir.g d~ficer Copy - Alphalieficai ~.o,~e br ~d+o.d sror+.. sK?.+o?r of s~°. S~e of Florido j- ~ E)RC. IDfAS ti~. 1679 - . sr~ „ . a ~ ~~~~;v ~ r~ ~ . ~~~~r. ~i ~ - ~ s ~ _