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3~ THIS FINANCING STATEMENT is presented to a tiling officer for filing purwant to the Un~ or Code: 3. MVturity date (if any): ,
t Debtorlsl (Last Name First) and address(es): 2. ured Par (ies? and address) For Filing Officer (Date, Time, Number,
~ , J~ A~iO - t ~i .~~C$?4 and Filing Office)
Olr HQtiL2H00D~ 1rL• II~C
1213 N 16 3T :_.~E~ ~ CQP.DED
FT PIEACE, FL. 2502 3 QED AWY 33450 r' T ! ~ -
~4I33450 FT PI6AiCE, ~i..
FII.B~ t 1841 AA C~Q
4. This financing statement covers the following types and/or items of property: X44 OrJ1~
'Z9
.Ars goons iss~an ~t mss. oe er ~ - . - •
rrnca~rKez Ba ~o~o ro,
5. Ass~~gqnnda{tJ Qf S~uretl Party and'
z Addressfes?
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6. The secured party(sl, whose signaturels? 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
placed on any additional and similar instrument that may be so severed.
This statement is filed without the debtor's signature to perfect a security interest in collateral. (Check ®if sol
~ O Already wbject to a security interest in another jurisdiction when it was brought into this state.
O which is proceeds of the original collateral described above in which a security interest was perfected:
Check ®if covered {pt~s ~,~al a~,alsRFoy~jPd. D Products of Collateral are also covered. No. of additional Sheets presented:
a
Filed with:
t JOffit Ft)LLSR AgCO I!!Ir C
fay: By: ~ ~ ~
S~gnature(s of De6torlsl _ S~gnature(sl of ured Party ~
STANDARD FORM -FORM UCC-1
c~' Approved by the Secretary of State, State of Florida
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