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THIS STATEMENT is presented to a filing officer for tiling purwant to the Unitorm Commerc~ 1 3 Maturity date (if any?:
t . Debtor(s) (Last Name First) and addresslesl: 2. Secured Partylies? and address(es1: or Filing Officer (Date, Time, Number, .
8011~=Igtlilos'tih~ Tilt dt~p ~ and Filing Office)
160?~' •Ae~ H Bo13~~roo~1, Iaa. F I L E D C O R 0~ D
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4. This statement refers to original Financing Statement bearing File No. L1~ 33~• - ° -
Filed with ~N ~'i Oate Filed 19
5 ? (~,pAh~l'gn, The original financing statement between the foregoing Debtor and Secured Party, bearing file number. shown above; k slit! effective.
6. D Termination. Secured party no longer claims a security interest under the financing statement bearing file nuRlbet' fttilVvfrib~e-
7. D Assignment The secured party's right under the financing statement bearing file number shown above to the property desuibed in Item 11 has
o-~ been assigned to the assignee whose name and address appear in Item 11.
~ 8. D Amendment Financing Statement bearing file number shown above is amended as set forth in Item 11.
9. ~ Releaa. Secured Party releases the collateral described in Item 11 from the financing statement bearing file number shown above.
10. ? Cheek if true. All documentary stamp razes due and payable or to become due and payable pursuant to Chapter 201, F. S. have been Paid.
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No. of additional sheets presented:
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Signaturelsl of Debtor(s) necessary only if Item S is applicablel. S~gna ur Is1 of Secured Party(ies)
STANDARD FORM -FORM UCC-3
Approved by the Secretary pf Stage. State of Fln.~da
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