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i THIS FINANCING STATEMENT is presented to a i~ling officer for filing pursuant to the Uniform Commercial Code: 3. Maturity date (if anyl: ~
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~ t Debtorls) (Last Name First) and addresslesl: 2. Secured Partylies) and addressl For Filing Otficer (Date, Time, Number,
P`~~ A~i~ ~I~ ?~~~`~is ~ and Filing Office)
o LF~F,I.A,ND ELAINS HOLLYt~00D~T FL• II'1~C
5913 ~'AYPAYA DR 2502 S FSD HWY ~19 ~~~Y ~ 8 54
FT PIEAiCB, FL. gr pIg~E, 1~ 3345~
33450 f P~cTo~cu~o
~ 4. This financing sta[ement covers the iollowing types and/o? items ot property:
~~E~~ 1`RASA.
nLL CONSUt~R HOII3~fi0LD GOOD3 LI31'SD AT R83ID$NC$ OR AT A.'dY Q~~~ T
~ PI.ACg THBY NAY B~B ~fOVED T0. ~vt7t
~ With The ~ception of ~`.ZI Househo2d .'lpplir~naes 4~2Q
~ 5. Assignee(s) of $ecured Party and
Addresla)
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5. The secured pa.ty(sl, whose signature(sl appears below, states that the stamps required by Chap[er 1,
? Florida Statutes, if any, have been daced on the promissory instruments secured hereby, and will be
~ P~aced on arry additional and similar instrument that rt~ay be so secured.
Tn~s statement is filed without the debtor's synature to perfect a sacurity interes[ in cdlate~al. 1Check ~ ii so)
~ Already wbject to a xarity interest in another jurisdiction when it was brought into this state.
; ~ whith is proceeds of [he original tollateral described above in which a secu~ity i~terest was perfetted:
~ Check ~ if c f late ar I overed. O P~oducts of Collateral are also cwered. No. of additional Sheets presented:
~ f~ledwith: -
~ '~Z = ~ , - G ~ / n~o xnrrc~ sgxvocEs
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Bv . `l-il-'~ L ' ~~i l,~i~ By:
f Siynature(s) of Oebtor s) SiynaturN i S~curW P~~ty(i~s)
STANDARO FORM - FORM UCC-1
s Approved by the Secretary of State, State of Florida
~ ~1~ Fl~ INr, nF~l ER ~~FV PE{ABETICAL c~~ ~
OR
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