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Bor 24FL-f Ed. Nov '76 /
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STATE OF FLORIDA
UNIFORM COMMERCIAL CODE - FINANCIPIG STATEMENT - FORM UCC - 1
THIS FINANCING STATEMENT is presentsd to a iili~~ officer for tiling purwsnt to the Uniform Commercial Code: 3.
1. Debtwls) ILsst Name First) snd Address . 2. Searod Psrty a~d Addreu * For Filing OHicerlDste, Time, Number,sndFilirg
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_ _ _ , , . ~.J, : _ ROCER POITAA$ lA
" ' ' G! EPK CIRCUIT CO T
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Thisfinancioyststert~ttoventhsfoliowinqtypes(Oritemslofproperty_/Chtckboxwhichspplrt.r~ FEe Il ,2 IO PH ~~Q
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Ali of tht household jumltun and furnishina~ etectrical and.~s applpnce~ !nc/udir~ rele~ti.sion ' ~
D sct; Phono~phs and neord ployer; rej~erotor; et~, and other personal proprr~~• now owned
and Ioca~M st tht ~estdenee oj tht Debtors ur the addrtugivtn aDove in Boz 1.
D `a Assigneels) of Secured Party and Addrcules) `
5. Check if true x[] The swr~s required by Chapter 201, F.S. have bean plaoed ort the promissory i~strumeni
secured hereby, ~nd will be placed on sny additwnsl and similar i~strument that msy be so secured.
l~cumentary stump.t attached to ort~nd note antf cancelfed
Thi; sceterr~t is fited without t1~e Dabtor~ sig~aturc to perfect a securiry interest in couaceral. (Check ~ if so)
? Alresdy wbject to a security intersst irt arwtha? jurisdietion wher? it v+rss brought into this state.
? wf~icA is proceeds of the oriyinal ooliatersl cfescribed above i~ which a security interest was perfected:
Check~it wvered: L`x~ Prooeeds of CoNaceral sre also carerad~Producu of Cotlateral are also covered. No. of additional Sheeu presented:
F r led weth: C/t~k oj the Cimrit Court oJ Coun ty, Flo?Wa
. Secured Party *
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~t~ STANDARU FORM - FORM UCC-1 . Mansqer
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