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THIS NNANCING STATfMArT is p~eM~d a o fiGeg offio~~ iw fiiinp purw~or~f b 11r Unitonn Core~rool C+od~: 3. A~oA,~iyr d~e I~f an~nl 9~80 1~
i. O~blods) (last Nan~ ~aatl and add~l 2. Ssand lloryr(in) ard odde'wle~) ~ For Fil;np Offiw (Dol~, tinN, l~kr~,
Chambers Ja~es E. & Fraaces ~ °~F~"°O~0'~
11t13 N. 21st St. P.C~. ~
Ft. pierce, Fla. ?3450 S. ~•'~i>?:RA.I. 7_~t'
k'I. ; I~:~'t~~, ~I:):~ 3~=~}0 .
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n,a ruw~ieg .aM~N ao~s d+. ronowi~w +w.s of wop.r~n
As listed on schedule "A" security list dated 9-12-75
~ s. A~pn.~W oF s.casd Po~t~r an Md~
6. TM ~currd patrlsl, wl+w~ sipnaAU.~s) op~p~ars bdow. slons Aa~ tIN stompa ~puiwd b'Y Cfiop~ 201.
Flaido 51aiAda. if arry. hare b~w~ plooed a+ ~he peanwstory iwn~ewrs a~cund l~~bp, und wiil b~
p~oc~d on an~r odditia~al ond ainiiiar iMnmrnt M~ot niop b~ as au~wrd.
This sbMnwM is fild witlwu~ N~e d~bbr's siqna~rre b pwf~c! a a~aRiyr ~sr in collolerol. (C~c# ~ if sol
? N~wdr wbj~d ~o a s~a+rih im~wst in awM~ jirid"i0ian vrfyn i rws 6rouyia inb this abi~.
? Which is proowds of Nw oripww! ooilorad daaib~d abw~ in wl+id~ o s~cariyr inlaest was paf~d:
Cl+edt ~ ii ooN~d: ~ P~ocwds of Collolwoi aR dao ao~e~d. ? hod~eds of Cdbt~eol are ol~o core~ed. No. of AddAionol Slwls praarM~d:
RNd wi11~ .
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I:A x'Iti~ICE `:C~
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sr= ~ sy,
~°Qa ~4 t~~ ~s~.~,R.d
p~ STANDARD FORM - FORM UCC-1
(I) Fifing C}~ce~ Ccpy - p~a~i~R~++ -~.~,,.a ar ~w~a ~a~ s~w+.. S~ae~cry of S~cts, swr. ~ po.;do .s:
_ _ . . E~~. IOE/tiS NO. 1679
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