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~ TH15 FINANCMK STATEIIABJT is preseMed b a filinp offiter ~w filinq pur~wM to IF» Unifonn ~oenn~rciol Gode: 3_ Moluritr dop (if ore~r=1 8 ~
1. O~bor(sl (Lo~ Nane fust) w~d addressles) 4. Se!cvnd Party(ies) and oddraN~ for Filrg Off'aK (Do1~. T'rwe, NumbK, ~j ~
Hone cntt Charles & Bett F~ GI.~' _ ~~'?~'~TCF; . °"d ~ '
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201~8 S. l.ttth.St. (.'~`7 S. 3-;'t';:^:1T_ H1~lY.) .
~ Ft. Pierce, ~la. 33b50 ~T. Y:~;F,G~:, i=LC;I:I~A 3345.0
~ nws +inoncinp sta,em.n~ ooren th. followa+p niv~s (w 7tansl of P~ope.+r:
~ As listed on ~schedule "A" secur~ty list dated 8-6-75 ~
~ s. Aaai~wW oF s«w.e Fa+p ona Aaa~...hd ~
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~ 6. The secue~! Po„Ylsl, wno~ ~wn~~s~ ovP.on b.+ow, ~r., ~r~oe ,h..=+~. ~.~:~.a br ~wp.. 2oi.
flwido 5lowles, if any~ have been plored m the prom~sswY instnin+ents s~cwed hatab~r, and wilt be
~ Ploc~d on onr oddiliorwl o~d simibr i~ntrunwnt 1lwt nqy bt os s~awsd.
# This stot~meM is fikd wiM~ou1 the d~bbr's sqnoture b perfecr o a~ourify irNe~est i~ oolbta+ol. (CINCk ~ if to] ,
~ O Alroodr s~ibNd to o secwiry intueu in w~wF~ jurisdictan wMn it wos brou~ht imo N~is sto~e. -
~ ? Whicfi is poaeds of fhe wginol cdloteral describsd obove in which o seawit~r imerest wos pw(~cMd:
~ C1»ck ~ if aorend: Q Praeeels of Collaterol we olso corered. Q Products of Collam~eol ore dso oorered. No_ of Addtiarwl Shee~s p~sser~d:
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~ STAN~ARD FORM - fORM IJCGI
! 1~ F i I ~ n g~f i c e r Ce py " AI phabetiea4 /~pw~d M~chad IoKW sw~~. s«?.+o~r of sak. sro+e of Ho*;do _
~ _ . . - D~C. IDEAS NO. 1679
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