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THIS fINANC.'tN6 STATEMBdT is prcserrl~d w o filinp officer for filinp pwsuaer b the Unifa~n Gonn~ncal Gode= 3. Mohwihr doa lif _
1. D~b1o~(s) (lost Plom~ F~rsH ord oddr~ssl~s) 2. S~cueid ~aty(ieil ord oddr~sales) ~ for F:ling OFf'~au lDott. Tin». tiumbw,
and Filinp Offio~)
Williams, Marion C, E GLE IINANGL ~
2101 Juanita Av. P O. FOX 3265
Ft.Pierce, Fla. ?3~50 { 0~: F~s;FI2AT H~'VY•) .
. r~~r.~~; ~t~ or.~~A 3~-~50 2;~~830
n~s r~cirg s~o+en~+~ ooK.s rd~ n~s to. ~+ans) of O.op..~r:
As listed oa schedule "A" securi ty li st dated 12-2-7l? S~~
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6. The ~ec~wed P~~Ylsl. ~wFioa siqno~wels) aPP~R bdow. syo~s Aat Mt stompa rpui~d !?'Y ChoPls~ 20~•
Norido Stowles. if anp• hove bu~' PEoad on the pranis~wy ir~stn+msnn s~an~d hers6~r. a+d vvdl b~ .
ploced un ony odditianol ond sinwb~ instrmn~k that moy 6~ os srawd
This sta+~nwa is filsd wi~ha+~ ~he debor's siprwtur~ b pafed o MaRi~y N+N~eat in odlaterd. (U»dc ~ if so)
? N~r u~N~t *o a a~aw~h ir~erest in a~oNwr juri~dction rvF+~n A wos brarqht iMO this ~otr.
? Whid+ is proae~ds of ~he orginol oollote~ol desuib~d obov~ in whid~ a ssawity 'aw~est was perfecNd:
U+eclc ~ if oorer~d: O ProcNds of Gdlaterot ore olzo coveied. ? Ptoducts of ColbN~ol ars dw coreeed- No. of Addtionol Sheeb p~esented:
FiMd widh
IC~~IC~ ~AGE~~.6~ ~?c~ ~r;~cE c~xp
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STAN~ARD FORM - F4RM UCC• 1 ~
(I~ Filing Officer Copy ~A!phabeticaE ~va~ br ~o~a ~oKt1 s~«~., s~rery ~ soo~ sr~ ar ~
_ 9 fXEC. IDE/1S NO. 1679
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