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BU- IOFI.-I t'J. No~: '76
519346
STATE OF FLORIDA
UNIFORM COMMERCIAL CODE - FINANCING STATEMENT - FORM UCC - 1
TNIS FINANCING STATEMENT is prosented to s tili~ oificer tw tilirg purwant to ihe Unitorm Comme~cisl Code_ 3.
1. Debtortsl (Lsst Name First) and Addreu 2. Seairod Party snd Addrcss * For Filinp OffioerlOate, Time
Office)
VAN CAMP, GARY L.
186 Dcmore Ave.
Port St. Lucie, F1. 33452
This finencing statertront COVers the following types (or itertu) of propMty: (L'heck box which appli~t)
AU oj tht housrhold jurnitu-~ and ju-nishing; el~ctrico! anJ gas applianc~; includinR tel~vision
~ setx phonogrophs and neoid pb-•~nt ~ejrigeiutor; ~tc , aruf othtr persono! property noN~ owned
and focattd ut !he rtsidrncr oj thr Drbtors at th~ aJdiess givtn cbo~+r in B~x 1.
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6 Assignee(s) of Setured Party and Addressles)
6. Check if true~x The startK-s required by Chapter 201, FS. have been placed on the promissory ins~
sewred hereby. a~d will be P~aced on any additional ancf similar i~strument that may be so secured.
[bcumentarv sramas attached to orirrirwl not~ and cancell~d
This statert~ent is tiled without the Debtws signature to pe-fect a security interest in collateral. (Check ~ it sol
^ AlreadY wbject to s seturity interest in anoMer jurisdiction when it was brought into this state
U which is proceeds of the oriqinal co:lateraf described above in which a security interest was periected:
~heck x if covered• [z1 Proceeds ot Collateral are also covered (~Producn of Collateral are afso covered. Na of edditionat Sheen presented:
F i led with: Clerk oj the Circuit Court oj Coun ty, F7orido
Secured Patty t
•~1~•~.-.~ ................................. ......................................................_......................................
Debtor ~
.. ................................................................ BY •• ^ r/r/••~ •--•~................................................
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Oebtor STANDARD FORM - FOR UCC-1 • ~~~
* Type juL and complett eorporotr nam~ 519346
19~ HAR -6 t,~ tl• 2k
Fi~tc Ant F~cc~r.co
S f'OGER F~G 1RAS~.
CLERK WRCUIl CCURT~
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