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presented to a filing officer for filing purwant to the Uniform Commercial Code: 3. Maturity date (if anyl:
THIS FINANCING STATEMENT is ~
1. Debtp?~1 ;t NameFirst~ aria adores:les?- 2. A~ec~~~~il~?~d~ OF For Filing Officer (Dace, Time, Number, F
(:UY ~AtiL and Filing Office)
cUPPELS, DONNA HoLLYwooD, FL, INC 4,7,~,~,~ 19E0 NAR -3 yg ~
1171 SE MAXI~JELI~ Li+ 2502 S FED H~IY
pgj,s FI,. FP PIERCE, FL. 33~+5o FILEO,tKCFECOitDFit
331+52 .FILE 8 SCUICfE CGUNfY.fEA.
ROGER PQITRAS
4., This firwncirg statement covers the following types and/or items of property: CLERlI C1RCllIT COUR~
RECL'AD lrrplrlEU_--
ALL CONSUMER HOUSEHOLD GOODS LISTED AT RESIDFSICE 08 AT ANY 4'~ ? 18if'r
PLACE TO WHICB THEY MAY SE MOVED.
5 Addressl~iof Secured Party and
6. The severed partylsl, whose signaturelsl appears below, states that the stamps required by Chapter 1,
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 collateral. iCheck ®if sot
? Already wbject to a security interest in another jurisdiction when it was brought into this state.
~ which a proceeds of the original collateral described above in which a security interest was perfected:
Check ~ if covered: O Proceeds of Collat ral ar also cover O Pr u Coll a e covered. No. of additional Sheets presented: ,
Filed with: ~'~~~~r-~
s
er- r t;y: ~
Signsturelsl of r 1 Signs r sl of Sscur lied
D FORM -FORM UCC-1
~ Approved by the Secretary of State, State of Florida
rn cn tue nmrcor v-AI cu~acr r~ n Ij . SIII 4At~~