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Bar 21FL-! Ed Nov. '76
495441
STATE OF FLORIDA
UNIFORM COMMERCIAL CODE -FINANCING STATEMENT -FORM UCC - 1
TNIS FINANCING STATEMENT is prasartted to a filing offiosr for filing pursuant to the Uniform Commercial Code: 3~
t. Debtorlsl (Last Name Firstl and Addrsss 2. Second Party and Address * For Filing OfficerlDate, Time, Number,andFilirg
WELLS, William T. do I+(yra H. office)
l~115 Poinsetta Ave.
Ft. Pierce, F1. 33;50 ,
l1-r'
4- This financing statement corers the following typeslor items) of property: (Check box which applies)
AR of the household jurnlturc end jurnislrirra; Nectncal and acs appliance; lnchedin; television
® set; phonographs and record pbyer; refiiaerotors, ett, and other pe?sona/ property now owned
and located at the residence of the 1]rbton at the addrcssgivrn above in Box 1.
? 5. Assigneelsl of Secured Party and Addressles)
6. Check if true[x,] The stamps required by Chapter 201, F.S. have been placed on the promissory instrumen
secured hereby, and will be placed on any additional and similar instrument that may be so secured.
Docu?nennry stamps attached to origind Hoar and cancelJod
Ij This statement is filed without the Debtors' signature to perfect a security interest in collateral. (Check ~ if sot
? Already subject to a security interest in another juradicYwn when it was brought into this state.
? which is proceeds of the original collateral described above in which a security interest was perfected:
Check[[lif covered: [x1 Proceeds of Collateral arc also covered.[]Products of Collateral are also covered No. of additional Sheets presented:
k riled with: CleNt of the Circuit Court of County, Florida
T Secured Party
1 . ~
r Debtor
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Debtor STANDARD FORM -FORM UCC-1. Manager
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1
495441
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S R~P0ITRAA.
CLERK CIRCUIT COUATrp
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