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~ INSTRUCTIONS 1. PLEASE IYPE ALl INFORMATION, arW Siyn wilh MII pant p!n S~p~alure must be tspi0ls on Fet~np 0~~~_e~ Cap~es ~
2. Cantatt ~dinp OHica fa fee x~e0ute o~ WG~?1ons~ intwmata~ _ 1
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STATE O~ FLORtDA Fo~ ucc-i
UPIIFORM COMMERCIAL CODE FINANCINCi STATEMENT FORM UCC•1 REY. 1981 ~
TNIS FiNANCING STATEMENT is presented to a fitinp otficer for tilinp pursuant to tAe Unilorm Commercial Codg: y
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UEBTOA ~lasl Name Fire1 il a Perso~) TNIS SPACE FOR USE OF FIl1NG OFf ICER ~ ~
NAME J]~jn~S Floor Fashions, Inc. Date.Timt,Number8filmpOlhcc ~8~~~~
tA 3196 North U.S. 1 `
MLILING AODRESS pierce, F1a. 33450 '
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CITY STATE 1
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m MULTIPLE DEBTOR (IF ANY~ Ilasl N~me F~rst ~1 a Penon) '~~n ~
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w NAME ~ 1~ i
~~B ~.Y 2~ Fii 2 J? ~
z MAII,ING ADDRESS ~
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2 ~ ( i E.~ ~ 4
O CITY STATE El~J~1~ i. ~ i
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~ MULTiP~E CEBTUR pF ANV) (last Name F~rs~ ~I a P~rso++) f
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lVAME
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MAILING ~!UORESS ~S~Q~
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* CITY STA?E
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SECURED PARTY (La~l :Jama Flni il a persan)
MAME S~ g~]t Of S'~. LLIClE'. CAL1i7ty
2A P.O. Box 8 -
MAILING AUDRESS p~erce, F18. 33454
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CITY ST AT E
^ MULTIPLE SECUpEO PARTY lF ANY1 Ila~t Name f~rst ~1 a Perio~)
NRME i
2B
MAILING AODAESS AUQ~T UPOATE
~ 4
CITY STAYc
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^ ASSIGNEE OF SECURED PAHTY (IF ANY~ ILast Name F~rsi a ~eryo~) VALIDATION INFrJRMAtION 5
NAME
3
MAiIING ADDRESS .
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C1T Y ST A7 E ~
; 4. Tnis FINANCIt1G 5T~ITEMENT corers lhe lo~lowinq Irpes w~tem~ ol property (~nclude desc~~phon ol rte/ F~operry on wn~cn IouteO
! snd orinEr o.' ~ecord wAen ie~uued? ii more sRxe ~s requ~reo, at!acn aaa~t~anai sneats 8'h'
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; Yale Forklift Model L51C-050 Serial # P161685 ~
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5. Pro~eeds of coi!atera~ are covered as proriCad m SecUOns 6~9 20J anA ~79 306. F S' e5 I/. No of addrt~onal Shaets psesen!eb. ¢
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s. F~~ed w~~hClerk of the Circuit Court _of _ St._ Luci.e County_ o
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~J A!i 4ocumentsry stamp tues due and DayaII'e w to become Aue and RayaD~e pu~suant fo Sect~on 20~ 2~. F.S . ha.a Dee~ Da~d
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i.~ Flond~ DocumeMary Stamp Ta~c is not reQuueO ~ !
- 9, Tn~s statement ~s hte0 witnout tne deDtoi e si9nature to pe~fact a secunry ~n~erest m co~~atsra~ (Cneck L: ~t so~ ~0. lC~eck il so) Z
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~ atready subjetl to a sxurty intereat in anot~e+ ~unsdiclwn wnen ~t was Oroupnt ~nro Ih~s state or de01c~'s ,l Debtor ~s a tr2nsmitt~np ut~f~~y ;
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~ ~ IOCdtro~ chenqeC !o Ih+~ slatl. Pr,eCucls ol collitera! are coraied
~ ~ wh~c~ i~ proteeds of th! oripinel collatera~ descnDed aDoYe ~n ~h~.~ a sacuri;y ~nteresl Na~ perfected
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~ ~ i ss ro wnich 1~e I~hny na~ I~peed - ~
~ SIGNATURE~S} OF DEBTOR{51
y w ~ acquired alter a c~anpe o~ r.ame, iaent~ty, or co~poreie structure o~ ;re
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a Q debtor or ~ securod party -
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13. ctet~m copy to: ~~rC~~ j~p~ ~pt.
NAME ~ g~k of St. Lucie ~~un . ~
' AODRESS Z SIGNATUHEIS)OF SEC ED
~ /~frlf P.U. BC~X H PARTY(IES} OR ASSIGN E ~
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aTr Ft. Pierae ~ ~ !
STATE E,, ZiPCODE
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3-0301-000-1 1• r~- rr;.; ~pproradDySecr aryo~Sbte.StateolFbnda
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