HomeMy WebLinkAbout1575TP 9 ae SM STATE OF Fl0lDA ~558StU67~
UNIFORM COMMERGAL CODE-FINANGNG STATEMENT-FORM UCC-1
Any forms used for Filing yyitls the Offiw d Sevetary of Sbte pcrsuarsl b Mre Uniform Commercid Code must be approved by Torn Adorns, SecrMary of StoN.
INSTRUCTIONS: ~
1. PLEASE iyPE Mis lore. Fold owly dorlg perbrolion fa w/ailrlg.
Rerw+e Severed Perry and Oebbr copies ord seed other 3 copies will) ulterlaoved taboo paper b the lilirlg dllcer. Encbse fling feed 52.00. p
~. 11 the space pro.ided for aey ites!sl orl the lalw n inodepc-ate the Itsells! should be conshued on odditiond sheeb. Drde.abltr S••aa" e. S"^10"'. Only one copy d such =
odditionol sheeA need b• preseatad b the hlrrg dficer will) the First three copies d the fiaondp sbtew enl. long schaduks d wlbterd, iadensu.es, etc. r.oy b. on any }
sire paper tllot is cow.enient la the secu^cd perry- Indicate Me eureber d odditioaol sheep attached. Encbse I.hrrp fee d f1.00 br each oddilional sheet.
~. tl coib-erd b cops or goods which ere w ere b becos• li[Nres, describe geeeroRy the real dole and gwc nave d rscord o~rner. {
S. When o copy of Me seariry ogreesent is used os a linoncieg sbterwewt, d is rpustld th01 it be occoreponiad M a cor.pleted but unsigned set o! these lorals.
6. tl a-no.tedgemsnl d fil;eg is rpuested indicate so orl rwwlber tllru copy awl eocbse lee cf s1.00. ?
7. N ll`ng with Cler1 of Circuit Court conwlt Chapter 28, FS., a bcol derE for proper fees.
Tha HNANGNG STATEMENT is presentad b o filing officer for filing pursuant b the UCC: 3. MATURITY DATE OF APIyt:
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1. DEbTOfyS) I1A51 NAME f1RST APD ADORE55(ES- 2 SECURf~ PARTYpES) AND ADORESS)ES) FOR FILING OFFKER tOwt_E, TwE, Nt:MRER~~
ADD i1lING OFEKE!
?allant, Jars irrnplaa Ina. a~.1~75'7
2001 ?rivo>~h R~oard 57.2 Calaraf]f~ Ath. ~$Q (~~ -~ ~ ~ 54
Port dt. Leis, ?la. 33452 smart, Tla: 33494
NAME Aft
=T lE~ R _~ 1~.
eI.ERK C1~IT~TCBUtT ,
RECORO vERIFICd
4. THIS FINANCING STATEMENT COVERS THE fOIIOWING TYPES IOR ITEMSI Of PROPERTY:
~~. ~ ~~ dfabtf~r R fl pflfra~ aal S~ "r• "iI ! ~~~ ~ f
lltrnittur~ and a~pliaof~s l~ooats>tt at diabtor•s swidaac~
inf3lndil~s biltt aot lititTltd tfD all f3ont~ats off' ltitahfw,
bfadrro~ls, liTit~ rofafle acid dinillr~ roaa, and all rslrpLa~rats
tb>~rio~ and aiddition tLas'a'to.
S. ASSlGNEE)S) Of SECURED PARTY
AND ADDRESSIES)
S~Ia)I
6. CHECR p: TRUE ~he stomps required by Chopler 201, FS. hove been pbccd on the promissory instrumenh
severed hereby, and will be placed an any oddi6onol artd simibr tnshumcnt that nstsy be so scarred.
This sbtemenf is tiled without the debb/s signature b perlect o security interest in colloterd. (Chedl m if so)
d dready s/rbject b o security interest in another jurisdiction when it was brought inb This sbtc.
O which is procecds of Nts origind wlbterol ~cscn~cd above in which o sccurily interest ova[ perleclcd:
Chet!®il covered: O Proceeds of Colloterol on also covered. O Products of Collotcrol ore dso covered. N~. of odditionol Sheets prasenled:
Filed with:
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~ Fly: ~ - SIGHATURE;SI Oi OEtlOfi51 y.
Net [t Mlee. LNG N[w Oal[[Ne. lta r01[•
YYY f 11 FILIN , OF~IC ER COPY At-PMAB[TIGAL
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~ 5 RETARI! Oi STATE
TATE Oi ilOR1DA