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41~45'~ Bor 21L-1 Ed Af~y '7U ~
STATE OF FLORIDA
UNIFORM COMMERCIAL CODE - FINANCING STATEMENT - FORM UCC - i
tHIS FINANCING STATEMENT is preiantsd to s filiny office~ for filirg purtuant to the Uniform Commetcisl Code' 3.
t. DebtwW (Last MartN FirsU and Addmss 2 S~wnd Party snd Addross * For Filinp OffiCer(Dats, Time, Numtx~,andFilinp
_.::._ii~:KY~ JOj.:: H i r1~:3Y . ~~J::rI :IAi FI:1r~::C..~, ~ Ottics) '
;,-2I t4ockin~bir3 ' llijl South Feieral Hwry
.crt Pierce, r'l. 33~5~ Fort Pisrca, FZ. 33~5~
1• This tinanciny sUtem~nt oo~s the followi~q typaslor it~msl of property: (Check box whtch ~ppltesJ
AO oj t/~e l~ous~hold jurninoe ~nd /iirniant~gt, elecnied ~»d a0r appllance; includlna te(tvLrlon _
Q setr` phonoarophs an0 mo+Q plrY~n~ nlriarraro~ etc, and othe~ peimnoJ properry now owned
or henaftrr ~cqvi~rd [n rrpJ~etnxnt rhmroja~d now or kh+njter /ocated at iht ntldenet oJ the -
DeDtorr et the oddreu ,~t?Yn ~Aore br Boz -
5. Ass+pneel~ of Secured Psrty and Addressles)
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A-Check ii trueQx The start~ps rpuired by Chaptet 201, F.S. hare ban pl~ced o~ tM promiswry instrurr~t
scc~red he~eby, and will be placed on sr?y additional and similx i~strument that msy be so sscured ,
[lucwmrntary rtamps utwclud to o.iain~/ wote mid eancelk~d
' sraterna~t a fibd without the Debtod si~natun to psrf~ct s s~writy interest in collatKSl. tCheck Q if so)
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~ ? Alre~dy wbjoct W a security inw~st in anothe~ jurisd~ction wh~n it was txouyht into this state. .
j ? which is prooseds of the wiqimt cotlaD~ra1 d~saibed abwe in which s aewrity int~rest rv~s perfected: -
~ -_'neck ~
x if mvered: ~ Proceeds of Co1LstKal are dso cwe~ad.QProducb oi Coisateral en also oovend. Na of sdditiona! Sheets presented:
~ F~~ed wi : Clerk oJ qu Clrcuft C~urt oj Coun ry, F(orlda
~ ~ • Secursd Psrty *
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. ~t~ ANDAR~ fORM - FORM UCC-1 ~Msnsger
~ • 7ypt Jii11 and comptett corporote namt.
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