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THIS FINANCING STATEMENT is presented to a filing officer for filing purwant to the Uniform Commercial Code: 3. Maturity date (if any1: 7^
1. Debtor{s? (last Name First) and address(es): 2. Secured Partylies) and addresslesl: For Filing Officer (Date, Time, Number,
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4. This financing statement rnvers the following types and/or items of property: ~fiditstfiCt'W~RAbA.
CLERK CtRCU1T }
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5. Assigneels) of Secured Party and
Address(es)
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6. The secured partyls?, whose signaturelsl appears below, states that the stamps required by Chapter -
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 secured.
This statement is filed without the debtor's signature to perfect a security interest in collateral. (Check ®if so)
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: Proceeds of Collateral are also covered. ? Products of Collateral are also covered. No. of additional Sheets presented: t
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By: By:
Sipneture(sl of Debtor(s1 Signeturels) of Secured Pa?tyl~esl _
STANDARD FORM -FORM UCC-1 -
~ A~ ~ _ ~ Approved by the Seuetary of State, State of Florida
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