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TH15 FINANCING STATEMENT is presented to a filing officer for filing purwant to the Uniform Commercial Code: 3. Maturity date (if any1:
1 Debtor{sl (Last Name First) and addresslesl: 2. Secured Party(iss) and address(esl: For Filing Officer (Date, Time, Number,
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Cam, FL. 33450 RECOp~. ~Er : ~e_~
4. This financing statement co ollowing types and/or items of property: w_ _ ~ 'O ~Z ~,j
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4`~:~ FI~1C~ TO ,~'?iIC:i T:~' 2`..r~r ^L .;0'l`'0.
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5. Assigneelsl of Secured Party and
Address{esl
f 6. The secured partyls?, whose signaturelsl appears below, states that the stamps required by Chapter 1,
I 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 cdlateral. (Check ®if sol
O Already wbject to a security interest in another jurisdiction when it was brought into this state. j
? which is proceeds of the original collateral described above in which a sacuriry interest was perfected:
_ Check ®if covered: O Proceeds of Collateral are also covered. O Products of Collateral are also covered. No. of additional Sheets presented:
Filed with: r v
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sy:
Sipnaturelsl ebtorls) BY Siyneturels of ured Partyliesl ~
STANDARD FORM -FORM UCC-1
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