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TNIS FlNANCtNG $TATEMH~IT is pre~enlsd b o filinp ofFicer for Rlirq punuonr b the Unifam Comr~id Go~: 3. MoMily doN (if an~?:1 1 81 ~
1- D~b~ortsl (lost Nan~ Fint~ and uddnssl~) 2. Secw~d Pbrtyl~es) ard oddnss(es~ ~ Fo? Filinp Offiau fDotit. Trnt. Numb~r. ~
Miller, Ray & Sheryl Cj
£~1~TAh7CE • O/d °~0a 4
1901 s. 34th. St. 3 ~r. ; :
Ft. Pierce, Fla. 33Lt5~ S. iT::'~
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_ r. ; :~;::C; , rL~ZIllA 334~0 ~
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This finoetiny stm~msnt oove~s the iollowirg yiP~s Iw ieems) d PeopwtY:
As listed on schedule "A" security list dated 1-22-76
s. Nsipr~s.1:) ot s.cve.a non~r ana Adawal.~1
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6. n~. sscur.a pony~sl. wl+a.e siynone..1•1 avwon bdow. sw»s 1hw the swmps requi~od br O~opler 201.
Florido StohrMS, if any. hore been pload on the promis~ory instrurnenb secwd Irtiby. ond will be
ploced on o~r odditionol and simibr ir?stn~mem thot moy b~ os ssarred_
~ Thii stotrnarN is fild wib+out ~he d~bbr's siynohrn b pMfM o~ihr i~taest in colbterol. (Ch~ck ~ if so~
? Alr+odf~ tubNd w o.~ouriryr i~aeest ~n owdn. jurisfiicran whr~ il ww b.w~he ina this dotr.
? Wl~icfi is proods of the a~yinol adlotaol described obwe in which o senrritp inte~est wos perf~dd:
Chedc ~ if eorerd: ? Froc~etds d Colbterol aee olw oover~d. ? Products of Golloarol are olw oarered. No. of Additiawl Sheels p~d: .
Fi led wi11h
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~ Siprwtur sl of DeF~1s1 Sg~ s) of S~cvr~d "+s)
~ STANDAR~ FORM - FORM UCC-1
(1) Filing pff~,er Copy _ Alphabeticei " ~ored by ~r~dw~d 1o~c~1 seo~+e. sea.m.y of sw+., s~o?e ot Ao.,do
s E~C. IpfAS NO. 1679
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