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UNIFORM COMMERCIAL CODE -FINANCING STATEMENT FORM UCC - 1
Any 1,.r ms sed for h:.ny wrtn ~^e q}•,ce nl $Kreeary 01 Stare p~n~ant to 'ne Un.l.,rm Curnmtr=~Y _.:n7e gar : e a..•o. !ei ~:y !~e `;r_•eryry ~r Stare Sate GI r ~~.•...i? i
~ ,NS1ftUCTIONS
1 PLEaSE TYPE Mis lo•m fold only otong prfaohon fo. morlrg.
i 2. Remoce Secured Parr c:.d Deb+or co :es a d send other 3 co es wwh . r rl a.ed caLur. r. t rh. 1,4.n r'. _
G p' n e e pop o g o .r. er Encio se t:hn.~ ice of {
i 3 li the ;owe Oro+.d!j fo. any ,reTfsi r•n the form n rnodc~uote the .ee•rr(sl snouli be cn~nn,ed en oddrrw•~oi ~et, preferab'v o• N". ~+,ly r•e copy of
s ucR oSLnoc of sneers need be c•r icered !o the hlrnq oH.cer w,rh roc I.rs• three •,p,es c! rnr I,n~~,;,n,T :r~arr men. ~~,-.g ~:,d..!.~s or co.!ore. a~. :ndenr„res cr_
mo. be ona+ysrzeDOperrhor.scon.en.enrfor the secured parr Ini,core the n,rmber ;,1 alA,•.one! si.ecrs orroched. ~nclase Li.na !rc of SZ.PJ to. each oddrr.o^a: .'-.rr
If collotero! is crops or goods which ore a ae ro become L.wres, gi.e the Iegd desvrp!•oc of the reol esro+e a:d nome of recor6 owner a reco•d :e;ser
~lf+m a copy of the securty ogreemmt used os o hn one rng store•.ren t• it rs reque Bred *hm .r be occompon,ed by o cowrp;erc0 bu! unsigned se• ai •ne sa
~ forms. An oddrrronol fee of f3 pp is recurred.
~ -6. Please sign Mrs form with o ball porm pen. Srgrwtmes roust 6e legible on otphobeticel and numencol coD+es.
7. 11 hl.ne rich Cled of rbrrut Covet consult Chooser ?S, f S.. a local =let: !a proper fees. _ -
Tttlt f7NAtiCING STATEMENT Ss pasented to o Kling officer fa filing pwseerrt to tM Uniiawt Carrwrtruol Code. _ 3. Morur;ty dot. rB sny -
Dcbras; ;Lost horwe find and oddress(esJ 2. Sacsrred ?afy(ies} and address M; - rot ra:p otr.r.r corr. i.rr. r.,..,tw......~
rd..e oHK.
^t= - . ~ ._..-ZTI S 'r.Y ?,'^L'.'f:,:'~, '"~'I ,•~.''/FI' .r-1."~.L
c This firrpnci s?otarrrent correrr tM follow: t - -
ng ng rva+ (or ileitis) of popertp: C • 1V ing C10
Suit, 1 Rocker,2 End Tables,l Color TV, 1 Dining Tabl~
Chairs, 1 B~drocm Suite, 2 Dressers, 1 Chest of ~ ~ -
Dra;•~ers, 1 Refrigerator, ~ Washing Machine, 1 Dryer, s. As,:g.r..(.) of s«,rred~wl;r wd.«.;,,)
~ 1 Searing t•Sacnine, 1 Vacuum Cleaner, 2 Guns, 2 Po;•rer Tool
- ~ ~U'~44
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6 '+a road porryrrl .hose rq+arre+s)appaors beb.. Ian eiror dra fomp •.w•d by Choor« IO•. rso,do Sa.•n i onr. Iv.e be«
ahead on rM pom.srr Memenq recwad ar.br. and .J be pbced o. a•r odd+aroa ad :nrJa ..rn,r..w rb rot x n rc.._K
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This stoteenent is filed witlrorrt tM debta't signature to periM o security interest in colbtarot. 'CMck $ if so;
i
} ~ Already subject too sKWitr imereet in onethe? junsdiciion whin it wos brought into this store.
~ whld. is prOCNds of tM w: nal cdlafvol dettrlbed pbeve in which o securit interest wos
gr ~ perfaclad:
C+eck :f covered ~ ?ro Coliorerol ore also covered. Iroducrs or ColloNrol ore also co.ared No. of odditionol Sheets presented.
iiltdwith: e c .`Circuit Court, 5t. Lucie Co.
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h= y:
r Signohrreis) of Oebtor;s} Signoh:re(s} SKVred foHy(ies)
• ~ - : ' --y t'• r,ar,~;.cat STANDARD FORM -FORM UCC-1 PaGE~,~I,,,~
•Wa•ea tzyr tM Secrttarn o/ Stara. Sane a ~ -