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THIS FINANCING STATEMENT is presented to a filing officer fo_r filing pursuant to the Uniform Corrunercial Code: 3.. Maturity date lif any):
) . Debtorls) (l.a~~~,~st~arxf addresslesi: 2. Secured e/st1 and adsfr~ess~iiesLw For Filing Officer (Date, Time, Nu
, _ AVCOVIAL SERVO OF and Filing Office) ~ ~pp _ _ -
BAVIS, MILDRED S HOLI,Y1i00D, FL ~ INC _ ~~SO -
RT 3 BO~QC 3?2 2502 s Fm HtItY '
~C FT PIERCEg FL. ~ Ffi PIERCE , FL. 33450 L
33450 Fmi.E ~ -
ti
4. This financing statement covers the following types and/or items of property: ~
ALL CONSUMER HOUSEHOI.E GOODS LISTED A~ RESIDENCE OR AT s
ANY PLACE TO MIHICH THEY MAY BE ROVED.
5. Assigrteelsl of Severed Party and
Addresslesl
19T9 SEP 20 AM f I: 13
~~I.EO AMD R CGP.D~ O
6. The severed partylsl, whose signatun:lsi appears below, states that the stamps required by er 1, Sf.LUCIEE C rY
ROGER ITRA~~ -
Floride Statutes, if any, have been fkace~ on the promissory ir?strurrtertts secured hereby, and will be ClEtgl ClRI~pT COUR
placed on any additional and similar instrument that may be so severed.
This statement is filed without the debtor's signature to perfect a severity interest in collateral. (Check ®if so)
O Already subject to a security interest in another jurisdiction when it was brought into this state. - 4~i~9~StD _
O which is proceeds of the original collateral desuibed above in which a security interest was perfected: .
Che~c ®if I are also covered. O Products of Cot:ateral are also covered. No.of additions) Sheets presented:
Filed with:
CO FINACIAL
By~ Signature(s) of Oebtw(s) Siyttature s of ured Yrty(itrs)
STANDARD FORM - FGRM C-1
Approved by the Seaenry of State, State of Florida