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THIS FINANCING STATEMENT is presented to a filing officer for filing pursuant to the Uni ~ Code: 3. Maturity date lif amyl:
I 1 . Debtor(s) (Last Name First) and addresslesl: 2. Secured Partylies) end address) For Filing Officer (Date, Time, Number,
JOg~gp~ ,rt,~iA & ~9I'[J~ ~~O ~~1000 Or and Filing Office)
2000 !1 ~1at street AollyWOOdi F1A Iaa• F~ EQ ;.":D RECORDED:
Ft. Pierce, !Za 33450 2502 S• Fbderal Hwy. ~ . _ . ~ C ~ U P~ T Y, F L A
Ft. Plsroe ~ Fla Z 33450 . _ , _ f• ! ~ p
File / 1763
4. This financing statement covers the following types andlor items of property: ' ~ _ ~ ;
~ All household goods located at the debtors residence or at arrF 79 f~ v r~
location to which theT •ey be sowed.
5. Assign~~~ ~4u ~r fR6Ut i~dC 0 !1 R f
Addressles
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6. The secured partylsl, whose signaturelsl 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 bB
placed on arty additional and similar instrument that may be fo secured. 1
3 This statement is filed without the debtor's signature to perfect a security interest in collateral. {Check ®if So1
D Already wbject to a security interest in another jurisdiction when it was brought into this state.
~ which is proceeds of the original collateral described above in which a security interest vves perfected:
Check ®if covered: ? Proceeds of Collateral are also covered. ? Products of Collateral are also covered. No. of additional Sheets presented:
rs Filed with:
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13y: fay:
Signstu elsl of Debtor(s) Signaturels) of Secured Psrtyliesl
STANDARD FORM - FORM U C-1
roved by the Secretary of State, State of Florida
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