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THIS STATEMENT is prsaanted to ~ filing oHlar for filing pursuant to tM UnNorm Commerdal Code: 3. Mstwity date (i1 arty):
t . Debtor(s) (Last Name First) and eddrw(ed Secwed PertYlias) and eddresa(es) cp faey OM+ar (DN. 4iwr. Mvnasr_ sne Frry OH.cal
Fields, Sherlock and Bthel B Bla~oez Finaaci~?1 Sezvices~ In . 4.946 j
2015 Franciscan Street 2506 S. Federal airy.
t?t • St • trade ~ FL 33452 Ft a PiQZCe ~ FL 33450 X79 22 PM 18
350979 bk 260 P9 1341 ~K~wxIo~rf?r~rctofluEO
4. TAfs statement rNers to originN FinancMp Statentartt beerirq Ffle No ~+grv:•T~~A, ~
1y,Fl~~,ilad with .St• L~iCie co~,ty Hate FNed ~V• 26 18 76 sy Ia,r~yrWT~T
5 Cl Continuation. TM original finertdrtg statement between tfta fpgoirtg CebtO/ and Secured Party, bNring fib nymp~taw.~~~~
E. ? Termination. Secured Party rto longer claims a security imerest under the f inancing statement bearirq file rumbar shown above.
7. ? Assignrrtertt. TM sacwad party's r?ptt under tM financing staterrtant bearing file number shown above to tM PrOWrtY described in Item 11 ices been assigned
to tM assigrtea whose Hence and eddnss appear M Item 11.
8. ? Amendment. Financing Statement beerirq fil• number shown above h emertded as set forth in Item 11. .
9. ? RNeese. Secwed Party releases tM eollnerM described in Item 11 from the financing statement beariry file nurnber shown above.
10. ? Check if true. AN documentary stamp u><sa dw and wywie or to become due and peYabte pursuant to Chapter 401, F. S. haw bean paid.
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455946
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No. of additiond sheets prasantW:
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BY" re( of Debtorls) Inecerary only N 8 is applicable). ey. Signetwet of ed Partylies)
. STANDARD FORM -FORM UCC-3