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Bor 21FI.-1 Ed. Nov. '76 ui
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519336
STATE OF FLORIDA
UNIFORM COMMERCIAL CODE - FINANCING STATEMENT - FORM UCC - 1
TNIS FINANCING STATEMENT is prssented to a filiny officer tor tilinp purwant to the Unitonn Commercisl Code: 3.
1. Debtotls) (lsst Name First) and Addrsss ?. Sscurod Pa-ty ~nd Address * Fw Filing Officer(Oate, Time, Number,and
Off ice)
3bILEY, JACK K., & DIAN6 L.
~271 S.E. HOLLAh~ -;.. °
,.. :~_.;
PuHT ST. LIICiE, FL. 33~-52 ~ '' - • - . . ~ . '
This financing staterrient covers the following typeslor items) of property: (Ch~cB box which applits)
Afl oj the household jumitun and jurnishing~ electricuf and aar applrartces incfudirq~ trle-~isio.-
~X tet; Phono~nphs and record Pbyt~; rejria~rotor; etc.. and othtr pe~sonaf proprrty noN~ own~J
and locaad a~ rh~ resldenc~ oj rh~ [kbron at rhe aJdren~iv~n above in Bos I.
Q I 5. Assignee(s) of Secured Party and Addressiesl
..................................................................................................................... ~
t;. Check if trued The stamps roquired by Chapter 201, FS. have been plsced on tha promissory inst
secu-ed hereby. and will be plsced on any sdditional and similsr instrument that may be so secured.
()~xumrntary stanns attaehed to ori~nal nofe and cancelled
Tnis statement is filed without the Oebtors' signature to perieet a security i~terest in rnllateral. (Check ~ ~f so1
^ Already subject to s security interest in another jurisdiction when it was brought inco this state.
^ which is Proceeds of the original collsteral described above in whitA s security interest vrss pertected:
Cneck x if covered• [x~ Proceeds of Collsteral arc also cwered.[~Producu of Collataal are also wvered. Na oi additional Sheets presenced:
F ~Ied with: Clt~k oj d-t CtrcuFt Couit oj County, Floridu
I Secured Party * . _ . . ..........................
.... ....... / ~~ ...................................... ........~......................... .................:,.... .
-' - Debtor ~~ ..
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, . .. .. ... . .
.......... .r/ ~i~r~4~Y~~..~N :1.. :.~ . .. . ......... BY .... .... ........C .......................................................
~t~ STANDARD FORM - FORM ~ C-1 Msn~yer
* 7ype Jirl/ and compfttr eorporote narn~
519336
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