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SATE OF fLORIDA Reorder Iron: AsseeJferris, s7 W. M.c~•,++ se
UNIFORM COMIhERCJAI CODE - fINANCINC; STATEMENT -FOAM UCC 1 Orlarrd•, Fla•A 3.f106 ~ttt
a•s tans cxd fa r... nq ¦,th ck O(La o1 Sesrrtrs N State n•wa+r is ttre Urdr+t Comrrrrtrrl Gate asst 6t iprrs.ea bs Seoett•y ra Sute• Slate of FrmOr
INSIRUCIIONS:
1. PLEASE TYPE Ha fare. Foid Dols alu~g prfaor.on iw naJrng
Remo.e Secured P,.rs or•a Debro. cocas and send other 3 copres w:rh mrerlec.rd cvbon pope. ro nc~ hLng ollrcer. Enclose LLn.T ire of SS00
11 the sp e•e pro+rded for ony item(s) the corm is inaderluore the rrr•..'a •,hw:d br c~:nt.nvcd en oddrrrono{ sheets, preler aFJy S~•+ 3~' cr A'. S0~• !}.ly r . ppy of
such o:e.!•ocal ;harts need 6e Drcac~rcd ro the Irlrng .(Neer w~rh the ~ r.• rhrer cocas .f r^c frnam rng ;tore..<ne Long ..!.des of rr.;t rr.rol r~. rrc .
moy be on o~y ::xe pop<r r'. ar •s con.en.cn•1cr the secured p=rry. Ind~corc the n,-..-cr cl a.2dr..r ••al ~.~cers oreoched. Enclose hfr~r :.e of Sj.Qp h,r ..._h ad~(rn •.-ol .sheer
1 If collorerol y craps cc goods which ore a ore to became Garures, gr.~e •he :e:d destnptror: of the reol estate and none of retard owrrr o• rcord lessee. t
1. Mhen o tact of .he securers agreement rs used os o Gnonc:nq statement, rx rrguesred Hoe .r be occompomcd by o co-+plered bur unsigned s<f of these i
foes. An a.fdrnana) lee of S3.O0 is rta<..red. !
E Pleose sign rA1s 1~.> w.th o ball point pen. S~gnaures mu sr be iegrble a+ oiyhabcecol and nwnerrcel copres.
II lilmg w:rh Cler?t of ~ucurt Cowl corgi:ulr Chopee. 28, F. S., or !ocol cltr~ for proper lees.
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Tr!tS FINANCING SIATEM_ENT s pre.ented xo o Gang o(Gctr Eor GGng punuont to the Un1Fo.m Commerciol Code: ' J Mcr4r:ry dote 'd r,ny
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Debro.ls) Ilosf Nomt finq and oddreu;n; 2. Secwed ?wtst7es o-cd nddrers:ev ' t.,..y Otr.a• oe'~.
t.r... w,,.w. o-a r.~..y O•rK.
liberty Life Insurance Company
Bears Nest
C/0 Ramada Inn, Oceanside (Assignee of the First Nat'l
Bank of Fort Pierce) ~
2600 North A-1-A p• p, Box 789
•~t. Pierce, Fla. 33450 Greenville, SC 29602 t i
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a This linoncing stobment covers the Following types (Or items) 0? property:
See attached Exhibit "A"
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Sr Asa:gntt +t of Serwod ?orry o•.d Address(es)
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~ . V.~ er rl. . u,~:: rs v u.r•. ••'.oe eoTpr .e r:
~ Fr Cnnt.r 61; ' ..r ~•.a.•.: r rr,r F..< _i
yr r . .v:' ; err, u^d ..G tr p%,.ed a~ a•r odlfo•~: c.-.f : r-y - • ter '
This s• atment rs L:ed wuhout rnr drbta't srgnarure to Perfect o srcur.ts .nrer<sr :n cullarernl. 'Ch<d d so.
~ - .ds subjrc• co a se:urery ~cr.rett in onaher junsdittion then it .~os bro.,.; a .nro GMs 'sr-,t<
_ , w•.,cA is Proce•?s o1 the :r;•t:nol collorrrol deu6bed obore in which a secures :nrereU wos perleded
. ~•r% ~ a+ered ~(~(?r ocrejs or C :Iat<rol ors als~,covered ?rnducrs of Coltote•c~ o•e cl:o ce.ered Na bf od.h•.u at S~rers Prr.•:.rrl
Frl~d r;t~so.ry~Eires.tone_,_Se~r~tary_Q~~ta_te_, Florida__.___.-__
.BEARS_N 1IBER Y_LIFE~NSURANCE _COMPANY__
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iSy - S:gnorure s; OF DeE,to By. Srynofure s: o/ Secured pores,.es - -
STANDARD FORM -FORM UC -1
Fir1x~ orr«: ~Pr - A!ptw6ertar
A, pre.. rd hr Sr+rat .ry n( Sts•e. S•a!e of Fonda
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