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TIfIS FINANCING STATEMENT is presented to a filing officer for filing purwant to the Uniform Commercial Code: 3. Maturity date !if anyl: /
_ ~ Oebtorlsl (Last Name First) aril address(esl: 2. Secured PartyGesl and addressles) For Filing Officer (Gate, Time, Number,
II~ tt ( e ~ and Filirtg Office)
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` ~Ll~i ~ K ~ 33 Stap~soeTn ?S
4 This financing sltatement covers the following types a(nd/or items of property`:( + Q~C~j~~1~
1 C ( ~ - r S ; l~c~ ~ S ~ J ~ C ! ( tt,~M vfRtflEO_
_ 7 5. Assigneelsl of Secured Party and
S e 1 ~ ~ ~ ~ Addressles)
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j 6 The secured partylsl, whose rgnaturelsl appears below, states that the stamps required by Chapter 201,
~ Florida Statutes, if any, have been placed on the promissory instruments secured hereby, and will be -
y placed on arty addrtional and similar instrument that may be so secured.
This statement is filed without the debtor's signature to perfect a security interest in collateral. (Check ®if so)
Already wbject to a security interest in another jurisdiction when it was brought into this state.
=7 which is proceeds of the original collateral described above in which a security interest was perfected:
Check ®if covered: ? Proceeds of Collateral are also covered. ~ Products of Collateral are also covered. No. of additional Sheets presented:
Fled with:
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$Y' By---- /
S~gnaturelsl of Debtorlsl gnaturels f soured P rty(~es)
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STANDARD FORM - FORM U C-1
.r ^ _ri^ r. ~ ~ ~~~~11 Approved by the Secretary of State, State of Florida