HomeMy WebLinkAbout0929 ~NSTRUCTIONS: 1 PIEASE TYPE AlL tNfORMATiON, and spn wiln pall pwM p~n. Sqnsturs must De Isp~D1e on filmp Otliter COpies.
2 Contact Fil~np OlNcsr fa le~ scf~uts a Wd~tbnal inlwm~tron • ~'r~::.::.`~".o~+` .:"v:: ~K.s
STATE OF F1,OpIDA ~ /
UNIFORM GOMMERCIAL CODE FINANCIN~ STATEMENT - FORM UCC•1 REV.1981
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DEBTOR ~Laa~ Nams Fint il a Penon) THIS SPACE FOR USE OF FiLINIi OFFICER
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MAILING ADDRESS b~8133
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~ MULT19lE DEBTOR (IF ANn (Ust MirT+e Firll if ~ Plr30~) ~ 6813 3
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ASS!GNEE OF SECUREO PARTY (iF ANY~ ~LSSt Nams Fuai+l a Versonl VAUDATION iNFORMATION ~
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~ C1TY -t ~~?'O~~?~ ~ STATE ?L WD~6 ~
~ 4. ~ni~ flNAHClNG S7ATEMENT tor~r~ Ihe lotlowin t
p Ypls w Nemt Of DfoQeAy (ene/u0e Osse~ipfio~ ol rHl propl~ty on etDitA loelfld
aa0 ownri ol iecwd w~en ipurrs~ I1 mae sDKa is rpwre0. alt~ch W~~tro~ai sneets 8 h' i U'.
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9. fn+s autsrt+an. u nMd veitnout tne dsblors sq~aturs Io perixt a secunty cntara~t m eW~~tera: (C~.eck C A so) ~ ~Cheek ~ if so? <
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avssdr auDNct to a saunty Int~nn ~n anather ~urls0+a~on wnen ii wss broupM mta th~~ at~ts w dsDta's ? DeDtor b a V~nsm~ttinp uUlily
~ fOtiliOn CAL10~0 t6 fM17t 6tit~.
~ Producls ol coltat~rs! srs corerW
L~ w~it~ ~s ptotNd! Of iM o~IpiMl tdlatsral d~iCnbW sbo~r! m w~icR a SeCUrit jiatereat was per}~cted.
as to wnke tns I+unp nas toDS~ ~ R 57~ P~~E ~~/S
604K ~~r~ S!(3NATURE{S)OFOEBTOR~S)
~ acawred dt~r s chanpe ol n~me. ~~~ntily. Or capo~~t~ structur~ o~ Ne
~ aGtora C7 s~eurW pany.
~ 3. Aftum CoP7 t0~. '
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NAME - ~l5_ec Frcr~~act~ ='inan~~ a)_ ^ervice~ ":o .
AODRESS 1~ ~~.Q,_n^~~ :etiter ;:?,u ~e 11 i 12. sr ATURE(S10F Ec
PARTIf lOR k
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STATE T;, ZfpGODE Q~ 6
(1) Fi~~ng Officer Copy STANDAR~ FOHM - FORM UCC-t Rpaowooys~cr~u
ry ot SUt~, SbN ol FbrW~
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