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THIS FINANCING STATEMENT is presented to a filing officer for filing pursuant to the Uniform Commercial Code: 3. Maturity date (if any1: ~
t Debtorls) (Last Name First) and address(es?: 2. Secured Party(ies and addressles): t For Filing Officer (Date, Time, Number,
J ~r `~O 1 /~C ~T/` J
~ ~ t and Filing Office) Q'~tryp
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4. This tirtarftting statement covers the following types and/or items of proper j .
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~ o ~'"or~ ~ s _ ~ . 48318
5_ Assignee(s) of Secured Party and
_ ` ~ ~ ~ ~ C A~ ~ Address(es)
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6. The severed partyls?, whose signature(s) appears below, states that the stamps required by Cftapter 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. (Check ®if so?
~ Already wbject to a security interest in another jurisdiction when it was brought into this state.
O which is proceeds of the original collateral described above in which a security 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:
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gy:
ig0'turels? of D~btorls) Signaturelsl of urW Partylies) r
STAN D FORM - FORM UCC-1
P~E~/ Approved by the Seuetary of State, State of Florida
(1f FILIH6 OFFICER COPY-ALFNABETlCAL atx?r~ /.,VV 1