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THIS FINANCING STATEMENT is presented to a tiling off~cer for filing pursuant to the Uni(orm Commercial Code_ 3. Maturity date (if any):
1. Debcorls) (Last Name First? arxl addresslesl= 2. Secured Partylies) and addresslesl= "71~!}?^. For Filing Officer (Dace, Time, Numb , ~
" and Filing Office)
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~ 4. This fina~?cing statement corers the Following types and/or items of property: MAr I ~7 2S fNl
~ '1? 's:ou.;ehol~ ~oo_?s~ furni+ure~ appZiances an~ consu..~?er ~oo~s
~ o:' e~rezy kin.i an~a descrzption o:.r_:ea a,. t;.s t,i^, e~ o:^
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t:,n ,1 i~7 .,~•,1 i'•- ,n< - i~i.L.,.) ~ ~ 5. AssigneelslofSecuredPartyand
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~ 6. The secured party(s1, whose sipnaturels) appean below, states that the stamps requireci by Chapter 1,
~ Flonda Statu[es, if a~y, have bee~ P~aced on the promissory insvuments secured hereby, a~d will be
~ placed on any addrtional and sim~lar i~strument that may be so secured.
This statemEnt is fited wi[hout the debtor's signawrc to periect a security interest in collateral. SCheck ~ if so)
; O Already wbject to a security ~nterest in another jurisdiction when it was brought into this state.
~ ? which_ is proceeds of the original coUateral described above in which a stturity interest was perfected:
Check ~ if covered: ? Proceeds of Collateral are also covered. ? Producu of Collateral aro also covered. No. of additional Sheets presented:
Fi1ed with:
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Signature 1 of Debtor(s) Si9natur (s) o ured Psrtyiies)
STANDARD FORM - FORM UCC-1 ~
~ R ~ ~ Approwd by the Secretary of State, State of Florida
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