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495443
STATE OF FLORIDA
UNIFORM COMMERCIAL CODE -FINANCING STATEMENT -FORM UCC - 1
THIS FINANCING STATEMENT is presented to a tiling officer for filing pursuant to the Uniform Commercial Code: 3.
t, Debtor(s) (Last Name First) and Address 2. Severed Party and Address * For Filing OfficerlDate,Time, Number,andFiling
SHIFFLET, I+larion do Betty L. Office)
X214 Indiana Court
r t. fierce, FI. 33450 ~ ~ : ~.o
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4. Th is financing statement covets the following typeslor items) of property: /Check box which apptiesJ
All of the household jurniturr and jurnWtitgt; Nectnca/ and gas appliance; IncludlttR trlrvision °
? set;, phonographs and rrcord playa; njrigerator; etc, and other persorwl property now ownrd '
and located at thr rcsidencr of the Debtors at the addressgiven above in Box 1. i
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5. Assignee(s) of Secured Party and Address(es)
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~ 6. Check if true[x The stamps required by Chapter 201, FS. have been placed on the promissory instruren
j secured hereby, arM will be placed on any additional and similar instrument that may be so secured
j Documentary stamps attached to original note and cancelled
This staterttent is filed without the Debtorf signature to perfect a security interest in collateral. (Check L-xl if so)
? Already subject to a security interest in another jurisdiction when it was brought into this state.
? which is proceeds of the original collateral described above in which a security interest was perfected:
Check[~if covered: [x1 Proceeds of Collateral are also covered.[]Products of Collateral are also covered No. of additional Sheets presented:
Filed vvith⢠Clerk of the Circuit Court of County, Florida
Secured Party * . .
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Debtor
/ fay
Debtor STANDARD FORM -FORM UCC-1 Msnager
* Type full and complete corporate name.
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495443
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