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lNSTAUCTIONS: 1. VLEASE TYPE ALI. INFORMATION, ~nd slpn with bail polnt p~~. Sipnatur~s mutt ba lpibi~ on Flli~p Ofilc~r Copier.
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Z, FU~1~d~iplqsl FlnanclnQ$tat~tn~nt nurnba ~nd d~t~tilW lio It~m 3, bNow~+ . . . .
3. Co~taet FIHn4 OHiar for tM sehWul~ or sdditbnal i~to?rtution.
STATE O~ FLORIDA ~ ~
UNIFORM COMMERCIAL- COD~ STATEMENT OF CHANGE - FORM UCC•3 REV.1981
THtB FINANCINO 8TATEMENT is pn~nt~d to a fittnp oHiear fa filiny puausnt to tM lMitorm Cpnnwrdal God+:
IMormatlon on ItMns 1 at~d Z mu~t prN ~xactiy wlth tM orlplntl Ill~p THIS SPACE FOR USE OF FItIMO OFFICEA
Info?m~tbn or N p~wiouWy am~~ded. O~t~, Time, Numb~r b Flllop O1fIU 858196
DEBTOR (Lat N~rn~ Fhst if ~ PNSOn) •
NAME
~A RI('~iAt~ A B~1N
MAllINO AODRESS ~ ,
- 2671 GRAND DRIVE
" CITY ~~CIE STATE 33452 329 20 71656
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C~ MULTIPLE DEBTOR pF ANY) (Last N~m~ Fint if ~ Penon)
~ NAME pSC71J6
~ 1B
~ Z MAiIIN(i ADDRESS - '
w
O CITY STATE '87 N~V ~ r~ .~ry
J ~ L
Z MULTIPLE OEBTOR (IF ANY) f l.m Mam~ Ftrst if a P~rwn)
p NAME
~C ~ i~'
MAIl.ING ADDRESS O~iij,t~ ' ~
# ~J i. . , t
_ . CITY STATE
SECURED PARTY (Lest Nams Fint if a P~rson) UPDATE
NAME
- 2A FLF~fJIQA NATIOTiAI. B~1NEC
MAILING ADDRESS
- PQ BOX 3469 AUDIT
CITY ~Z~ STATE FL 33448
MULTIPLE SECURED PARTY i1F ANY1 (lsst Nam~ First if a Parson) VAltDA710N 11~lFORMQTiOt+!
_ NAME
2$ -
MAILING ADDRESS -
CITY STATE
3. This statem~nt rei~rs to oriyinsl Financinq Ststement b~aHny Fil~ Number 656427/QR ffit 432 ~C 180 snd filed with
7he oriyi~al wu flied or~l~ 1C ts
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Continuiiioo. The oripinai tinaneinp statemtnt batwesn the to+agoiny Debtor(s) and Sscur~d Party(iss) b~arinp tita numtrer shown aDOVe,
' y~ is stiU effsctive. -
5. i9~~rmtnation. Sscured psrty no ~on9~r claims ~ seeurity interost under the (insneiny statemsnt bearinp fite number shown above.
s. ? Pa?tial Som~ oi Secured psrty's rightt under the Financi~9 Stat~ment h~ve been aulyned to the assiynee whose nsme and sddrsss
Assiynmsnt srt stt torth in Itsm 11. A detcription ot ths collsteral sub~eet to the assiy~ment is elso sgt torth in ltem 11.
? Full A!t of Sscy?~d Party's rlyhtt undar the F)nancing Statert+ent hw~ b*an ~tsi9ned to the aseipnee whose name snd address ~re
Aaiynme~t s~t forth in Itam 1L
' 8. ? Am~ndm~nt Finsncin4 Ststemant b~srinQ fil~ number thown aDov~ is ~rMndsd es set fo~th in It~m 11. SiQnature ot Debtor requirsd sf
! It~m 74 untets am~ndmtnt ehaoQts only nams oi addreu of ~ith~r party. #
9. ? RN~ss~. Sxur~d patty rtt~ssss oniY th~ ~oll~t~r~l d~scribed In It~rt?11 itom th~ fin~enciny stst~ment bearinp fils numDer shown ~bow. ,
? Ch~ck (t tru~. All docum~ntary stsmp tex~s dueand Fayrble ~t te bxorn! du* ind p~Yw~e purwant to ChsptK 201.22, F.S. havs b~sn paid.
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, 1 j. If~ mon sp~u is r~qulred, att~ch additionsl sho~ts $K x 11.
Z984 IIJGIl~ UINC 120 H~RSE PCIWER ID# 790716
1984 TRAILER 0 ID~ C7tID131848
~ - ~ go~x 564 P~~E ~53
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' . No. of Addittonal , SIC~NATURElS1 OF DEBTORIS) N~cesw?y Only
j ShNts D~~~ted: For ArrHndm~nt. S~s Item B.
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i Raur~ Copy to:
I NAME 15. SIGIVATUREIS) OP SECUAED PARTY4IES)
~ AODAESS OR SSIGNEE
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CITY •
STATE ZIP CODE ~ ~r
I~
~ STANOARD FORM - FORM UCC-3
Approved by Secretary oi Stete, St~te ot Flo~ids
FILINd OFFICER COPY Frve rrEM oe-»>
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