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- - ~ ~ ~ p•esentsd to a !d~nq officer for filing purswnt to the Uniform Comrr»rcid CoW~ 3. Afaturit date (if an 7:
- '.4NCIIVG STATEMENT 's I Y Y
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.~,lorisl (Last Name firstt and addressi esl i
2. S.cured PartYt ies} and sddrsss{ss? 4~ 4O Fo• F.i.~q Ortcer iDate. T:1+~e ^~..•*or.. r~ c.:~-y O!rre:
B. curl ~ Personal Rtsrift Plan inc. ' 1919 h0~ 28 il~ 12
1612 S. 27th St. ~ P.O. Box 3847
t. Pierce, Fla. 33450 i h't. Pierce, Fla. 33450 FILEO ANC ~fCOtt~EU
E ! ST.LUCIE CCUN1Y.fl A.
_ _ _ _ _ _ _ ~ RQGER POITRAS
- CLERK C(RCUI1 CGU~T
- ~s t~nancinq staternant co+ers the fottO+rtnq trDes for items) o! prone•ty i
FECCrn
190 Curtis Mathis 25w 8emote Color TV q -
:..odes X5768-Serail X95756979 - -
' 5. Assignee(s) of SacurW Party and Addrassiesl
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~ ~ 46''x'404
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- secJrM partr!sl, wMse rqW~. e's1 Koe~s t+or. ststes tr.at tYr stsr.rps .rr.r<o rr t:n~oter 701 f tor.d~ Surutes..t snr. ne.e !.eer, ~
r re•] on lM ann+.worr .r~suwre.+n tru.rd rwebr. vii w+;~ 1e daceO o•. rt aeei•t.o.a: aid s~m•ti .•ntr,...rr.t roar mer W w vowed ~ -
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I ' ms statan.ant is filed without the debtor's signature to partact s security intarast in collatarsl. (Chack~if soi
~ Already wbjKt to a sacurlty interest in another jurisdiction when it ws brought into this state.
~ ~ ~ ~ which is Wot:eads of the original tollatNel described .bow in which a security intorast was perfected.
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^e~k ~if covaitsd: ~yroceeds of CoiNteral are/a~ls~o~~c~ov.rad.y PrTO~d~u~ctjs~of Co/h!a~u~r~at ar. aho covwad. Na of additional Sheas Pr.santad: _ _ .
=~IW With: -W~y~~W-fiMFii~T'--ir~.~_----
Persots gift Plan, Inc Ft. Pierce
_ _ BY _
~ Signature{s) of Debtorisl Sigrsatura(s) of~~Securad Putyliesl
~ cTANlfleRfl C(1RfU1 Ff1RM 11(`C_'t f1A~alL~ ~