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O~i ~0 ~ y~ 1~ ~ HULK TRANSF$R AFFIDiAVIT LISTZNG CR$DITORS
31r9965
~ STATT OF FIARI DA
County of st. Luc~.e
James L. Middleton
, of la~rfui age,
being first duly s~,rorn,on oath statos that he the aeiler ~
in that certain contract for the sale of ase~ta dated
Oc_to+.
;~1, 1975 betWeen James L. -Middieton as seller
. and Robert C. and Betty L. Kusser ,as byyer
~ That this affidavit ie made pwrsu~ant to the terma• and
pravisfona of Section 6-104 of the Uniform Cc~amerciai Code
( F. 3. A. ~ 676. 6-I 04 and i s f urni s'~ed to the abo~ve nanaed
buy~er in connection xith the sale and transfer deecribed and
referred tQ in the abave mentioned contractj ~
;
T~at the folloxinq is a true, canpiete and accurate ~
list of ail of the creditors of affiant and of aii peraons
riho, to the kno~riedge of affiant aesert or have claimed
to aseert one or more claims against affiant together xith
the correct business addressea of each such creditoar or-
ciaimant and the amounts due and o~ing to each creditor and
claimants xher~ known to ~,iits ~
Name of IIusiness Amount Admitted or .
Cre_,_
ditor ' Add~ress_ Of Ciai~ Dis ~ut,= ~
Marion J. Nicholason-Ft. Pierce, Fla. ~2,050.00 Admitted
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- Af i nt ~
~ James L. Middieton
~ Subsc ' and sworn to before me thia
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~ Z'~renty First _ day of October - lg .
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a My canmiesfon expires,.,i. ~~w,;'-;,;~~;
~ ?~rahr IIJKIC SfA1E Oi f[OR1QA AT. ~ • fi~ ~4 • .
~ ~~ON E~MRlf r?~. t; i s .
~ONOfO tMty QENERA M ~A
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~ ' r~19 oo~ t.. : „ = xotary pub~ic -
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