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` INSTAUCTIONS: 1. PLEASE TYPE ALL INFOFWATION..~.~„~~~ 5~.,~. a»~. F~~ 15 414
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STATE OF FLORIDA 5 ~
UNIFORM COMMERCIAL CODE - FINANCIN~ STATEMENT - FOAM UCC-1 REV. 1981
THtS FINANGNO STATEMENT is prsssntad to a Hfinp oHlc~ for HI{np pursuant to t1w Unlform Cortrnerclal Cod~:
DEBTOR (Wl Nam~ FM~I it ~ PKWn) TNtS SPACE FOR USE OF FILIN(i OFFICER
NAME , Wt~. Tim~. Murtib~r i FYlnp OH~t~ ~~~~0
~q Vincent. Robert
MAIUN(i ADORESS
1216 S.W. Cynthia Street •
cm Port St, Lucie STATE Florids 33452 P3 a2 ~
~ MUITIPLE OEBTOR pF ANY) (lisl Nam~ Fkst a Pwsonl
X ~
Q NAME
~ ~g Vincent, Carol FMILEO Ah0
i IiAiIINGA00RESS ~WER FO~TL ~ r
= 1216 S.N. Cynthia Street ST. LUC1E CC~::i'=. ft..
0
~ ciTr PoTt St..Leicie STATE Flotlda 33452
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p MUITIPIE DEBTOR pf AN1f) (Last Hams First if ~ Psrsonl
NAlAE
,c ~21060
MAIUNG AODRESS
•
4 qTy STATE
SECURED PARTY (las! Nams Fest il a P~son)
NAME
2A Cochran, Ra? ~
MAIIIHG AODRESS
P.O. ~vx 494
c~rr gt. pierce, sT~re glorida 33454
AAULTIPIE SECUREO PARTY pF ANY) (USl Nam.~ Fvst il a PKSOn)
NAME H~TUE.'r~ 'IYSII~C
2B Ksrber, I~an
UAAIIING ADDRESS r(~$~(1 ~!like AUDIT URDATE
Same address as above (2p)
C~~y STATE .
ASSIGNEE OF SECUREO PARTY pF AN~) (last N~rns Fint if a P~rsoa) VAl!DATION INFORAIATtON
~ NA~AE
~ 3 ,
~ MAILING ADOpESS
~ p~ STATE
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~ 4. Tnia fINAliCiNG STATEMENT cown ItN Id~owlnq ryp~s a itsms ol propMr (~^~IuO~ Oescrrp~ron ol rN~ propertr on wrtrc~ lout~tl
~ end owner ol i~cwQ wMn iepu~n01. 11 mors epace ~s rpuirW. aitacn ~dditqnat s~Nts 8Yi' : 11'. ~
A1l inventory including xomen~ shoe~, jeWelry, puraea, et~... and all ~
~ f ixtures and signs relating to the buaines~ knam as The 777bug Shce Stor~ ¢
~ " aka The One Price Shoe Store, at 800 Virginia Avenue, Suite, 34 , Ft• g M 4
Pierce, Florida. o ~ ~
5. wocwos oi ca+at~ni an co,~.w as pro,~o~a in Ssct~o~s e~v2o3 ana s~ 3oe. F S 7. No. of aCOifional S?+Nts pns~nf~d:
p 6. F~:ww++~~ Clerk af the Circuit CourtL St. Lucis Co. Florid
~ 8. (CMck ~ 1 C1 AN Oocumsntarp sUn+O tu~s dw aW WY~ a to D«.ome due inC D+Y~ DunuaM lo Saction 20122. F.S.. MN Wsn WiO. Z O ~
~ '~ftorida Docurt+~ntuy Sbmp Ta,c is nol rpu~r~d Q LV
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~ 9. Tnq stal~.m~nt ~s fi1W wittqut tM dWtola si~ryturo to p~rf~et ~~eunty Mtsrest ~n ediaNrN ICe+eek ? it sq ~ 0. (CMCk ~ it ~o) ~ M~
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~ ~~ttNQr fuOj~Gf ~O ~ NGUritr infMfl in anotna IunsO~ctia-. wM~ it was Wapnt In10 tAq s4U C~ GOtOr~ ? D~DtW i! ~ t~~n~mitli~lp utilitr •
g bcatwn c~,anp~o to tn~~ ~tau. rJ Produca ol cd:at~rai an corK~d 0 ~
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~ u wMCh is p~oCNds ot tM alyln~l cdlatNa~ d~fcriD~d aDOq ~n wAic1+ a sKUntr 1ntN~st w~~ pM~CIW.
~ Li q to wfltt~ tM liliny hp I~pNC-
~ SICaNA ~OFi~S)
? Kq~Mb ~tt~ ~ cnany~ or nam~, w~+aitr. w capa~u struciur~ ct ine
C owtor a rJ s~c~~so vanr ~ G~G~
13. RNum copy to:
NAME R~1 C~C~~II A
~ ADORESS p~ Q• H~C 494 ~ 2. SI TURE(81 OF SECURED ~
pARJYPE$j Oj?_ASSIO
fi P
c~rv Ft. P erce a~o?~-. ~'f~
~ 8TATE nP~~ ~G
~ (1) FILING OFFICER COPY STANDARD FORM - FORM UCC-1 A~o+MDySstr~taryolS?a:e.St~tsolFSpnOa
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