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STATE OF FLORIDA Retrder /rtre Assx.lEnris, S) W. YicAisrr Sl.
UNIFORId COMMERCIAL CODE - FINANCfh', STATEMENT -FORM UCC 1 tl.landa Earn' >2f+Ot
~s 1. r•s r.ve to tnny anA Ue Ofbce d 4urtry el Sute wrsratt tt tY Us.l.~n C~rweruaf Code tact tk taxe+M er Stuetr? W Sirte. Sure M FIa,M-
fNSFRUCTIOKS:
1 PLEASE TYPE N,s lorn Fold on!r alcny perlcrorron For morbnq
Remove ~ecurH P,.cr r.•~ Debtor cop.et and serve other 3 copies wah mrerlea.ed corlan paper tr the INirg officer. Enclose h(.nq Fee of SSOQ
7 N the space pr Frd for ,ny rttn: sl rr the lpr n+ rs i^. ode9v ott tkr rtcr••'.1 •.r.r.to to c.r, •.n~ rl en odd.tion al s~eNt, cr••4rnbiv 5••. ;r e"• _ ' :)r+lt on. •-opt of ~
•.••ch odd,troc.p ~,!>.r. -eed b« pr.rneed to the I,i,n9 af6c er wart the hr~.• •~-rr. ccO era of .r,. F,na^; u•q aorta. nt t,cmt L• 4,~d.,1r. of coiloter of ,n~enr.,•r er.
,~oy be on c^s ;rrr pcr~•-that r: convcn,enr for the secured ports. lnd.cm+• mr } a!1 no••ot •.here; attached Ercl„se h:,,,~ frc •,i u_pp Lsr rut c. ndl,ne, thtet
IF -ohotewi rs c+ops o• goods .h:ch o.e ue ro became G.rures• g,ve the I ,a: de scr.pnan of the real eswte and name of record overt. a r-cord lr•see.
S. then o copy o] the secunrr ~Sreement rt used os o Finmcrnq srmtmrns, rt ,s re9,reued toot it be ouornponted by a carrplertd !wt :ns.gned te+ o) these
forma. An odddronal fee of $3.00 is reauirtd.
6. Pleoat sr gn this form w,rh o b~R point pen. $rgnorures must be legible m olph obetrc al cod numencal ropes.
7. li 61inq w.tlt Clem of Circuit Court consult Chapter 28, F- or local clerk for proper fees.
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THIS fIN_AN_CING STATEMENT is prnented to a li.inq oFlictr for filing pursuant to the tin.Fcrm Com_merciol Code: J Motuny date cif onv
Debtor; s; floss Name EirsY and oddress;esi I Secured fortyies and addrefs'es'~ ^ _ `A 1 <a. +~y p.rNtr nose
i.wt w,..r.ee•. o.e f.f..o Ott+.;. ~ i
Bears Nest Liberty Life Insurance Company E 13
c~ Ramada Inn, Oceanside (Assignee of the First National j
2600 North A-1-A Bank of Fort Pierce) I
Ft. Pierce, Fla. 33450 P. 0. Box 789
Greenville, SC 29602 f
t 1^.n t ~orcinq stoHm•nt covt•s tht iotlowinq types (q items; o! property: j
See attached Exhibit "A"
,I S Assiynt•Isf of Secured No.ty and Address(es)
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_ h] V.'••~+:. ~ ~ - r... r. Nt tNi~ • - 1 •`or rlr V :...;w of is ~-I..Vw . r..r~. -r t.. .
„r .1,. p.., -V f. . ~ . ~ tr .r_ ~ .d ~sr rf a ~rr rl.l.e. rot s•. .b-. ~ .,..t . ~
This s•-~•tment is /.red without the debtor's siq~orure to perfect o security :nternt ,n ;~U~rerol. 'Clyd so - - - _ ~ -
A6tudy s~~L,ec• ro a se: writ. ~nerrest rn onofhrr jurisd,ction when it ..-as b•ovgkr .nto this stMe.
whisk is prorte3s of rht or:yinal cpllorerol des:ribed above in wh{ch o uso•ds . aerest was perfected
d ro•eyed x~( Hyer ds et CoRobrol art oleo covered. " Hoducrs aF Collateral ere ui•o ca+ered No of orr:Lopr al Shtets Prtserre•1 _ - ~ - ~ - ~ -
F,!ed «••h~oye~P~.itra~,_Clerk_Qf~9~~t_s~_ St_._lucie_Co~nty,._Florida _
BEARS_@~ , _ LIBERT _ LIFE _INSURANC COMPANY
S.gnature'sl of Dtbt f3Y. -
Signoturesl o/ Secured ?arry,retr
STANDARD FORM -FORM UC -1
(l) filing OTTicef CGpy - Esil})3aEiCtict]) p+o vrrl c+r ~'crrra•y of S• rr.-, Srirc of For .ia
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