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Bur 24FL• / Ed. Nuv '76
5U'763'~
STATE OF FLORIDA
UNIFORM COMMERCIAL CODE -FINANCING STATEMENT -FORM UCC - 1
THIS FINANCING STATEMENT is presented to a filing officer for filing pursuant to the Uniform Commercial Code: 3.
t. Debtor(s) (Last Name First) and Address 2. Securod Party and Address * For Filing OfficerlDate, Time, Number,andFiling
KF"718F.DY, Robert ~ Lori Office)
1381 SE Rivergreen Circle
tort St. Lucie, F1. 331,52 ,
11•ki -
4• This financing statement covers the following typeslor iterr?s) of property: (Check box which applies/
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Alt of the household furniture arrd furnishing; electrical and Aas appliance; including television i
set; phonoa?aphs and record player; rejriaemtor; etc., acrd other perwna! property now owned ~
anJ located at the residence of the Debtors at the address given above in Box ~
ca Assrgnee(s1 of Secured Party and Addresslesl
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6. Check if true0 The stamps required by Chapter 201, F.S. have been placed on the promissory instruments
secured hereby, and will be Placed on any additional and similar instrument that may be so secured..
Uocumenrary stamps attached to original note and cancelled ~
f This statement is filed without the Debtors signature to perfect a security interest in collateral. (Check ~ if so)
~ ? Already subject to a security interest in another jurisdiction when it was brought into this state.
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which is proceeds of the original collateral described above in which a security interest was perfected:
Check~if covered: ~ Proceeds of Collaterel are also covered.(-]Products of Colateral are also covered N0. of additional Sheets presented:
Filed with: Clerk of the Cimrit Court of County, Florida
Secured Party *
Debtor _
~,(,~xin. By ~
Manager
Debtor ~ STANDARD FORM -FOR CC-1
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~ • Type full and complete corporate names
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