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THIS FINANCING STATEMENT is presented to a filing officer for filing purwant to the Uniform Commercial Code: 3. Maturity date (if any): .
t Debtor(s) (Last Name First) and addreulesl: 2. Secur~ Parrylies) and address(es): For Filing Officer (Date, Time, Nu
.~O - ~ and Filing Office) • _ ,
3224 S. 11.8. /1 ~ Bo~]ly$ood, lea Inc. ~ = c~ ~ n
!'t.. Pierce, Flerldt 33450 2502 S. moral H~
~ Pk. Pi~eroe~ tLa 33450 9~ ~~'7~
~ _ file f 1699
4. This financing statement covers the following types and/or items of property: t f
~ I ~ Q : c 0
All can Baer bawebosd good leeated at the debtors r~atdence - pp
or at ~ rt cfiber l~ooattan to trhia>z tLey iq? be >lo~d• ~ ~ 1~ -
y
5. Assigneets) of Severed Party and '
Address(es)
3
1
6. The secured partylsl, whose signature(s) appears below, states that the stamps required by Chapter 1,
Florida Statutes, if any, have been placed on the promissory instruments secured hereby, and will be
_ dated on any additional and similar instrument that may be so secured.
b This statement is filed without the debtor's signature to perfect a security interest in cdlateral. (Check ®if sol
O Already wbject to a security interest in another jurisdiction when it was brought into this state.
CJ which is proceeds of the original collateral described above in which a security interest was perfected:
Check ®if covered: O Proceeds of Collateral are also covered. O Products of Collateral are also covered. No. of additional Sheets presented:
F~ledwith:
5100 In0• ~
By: By;.
r
Signatura(s? of O tor(sl Signsturelsl of Secured Par y(iesl
STANDARD FORM -FORM UCC-1
R Approved by the Secretary of State, State of Florida
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