HomeMy WebLinkAbout2415 INSTAUCTiON$ 1 PLEASE TVPE A~L iNFOpYATIp?J. uW spn rr~lA Dal~ pan~ p~n Spnalwes mu11 De ~sp~D~e on Fd~.iO 011~cCr Cop~l3
n~~ ~ f~ll ~n a~p~nai F~nancinp St~IMnMt numpK an0 OaU Ii1W pn ItMn J. DNOwI ,3
t~ ~ Contatt F~I~nQ OII~CM fW fN SCMtluI~ or a00~tanai ~niwma~~on ~
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CTA~~ AC CI ~1Q1~1A Seminole Form UCC-3 ~
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UNIFORM COMMERCIAL CODE - STATEMENT OF CHANGE - FORM UCC-3 REV. 1981
TM~S FINANCINO STATEMENT Is pns~nl~d to a fllinq otHcK tw tlllrq purauaM to tM Unllwm Comn~clal Codr
inlormstwn in dems t and 2 must apr~ eracUy wrt~ !ne orpmal bhny mlormauon n TM~S SPACE FOR USE OF FIUNG OFFICEF
as prer~ousiy amsods0 Date. i~me. Numbar 8 Fd~np Othce
JEBTOR ~USI Name F~rst ~I a Person~ ~ Q2 z 8 0 4
NAME RpJEN V . PATEL
,A F ~ . ~ ~ G _ r..~T---, . ~
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MAiIiMG ADDRESS 1301 DELAWARE AVENUE _ , , ~ _ _ . ` , ~ . .
FT. PIERCE FL. , L: . _ C';r'.~. ` ~
' CRY $TA1E ~ _ ~/~j~
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~r MULTID~E DEBTOR pF ANYI !last Name Fnst ~I a Pe~sonl ~~v ~
" NAME i ~O • ~ L-. _ ~
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Z MAILING ADDAESS ~
Z I
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~ CITV STATE ~
~ ' '90 FEB -1
MULTiPLE DEBTOR ~IF ANVI ilast 4ame F~rs~ a Personi 102 2 8 0 4 ~
NAME ~ It
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~c ~ ~ IL/E~U :
MAILINGADDRESS ( nO~liLj{~~ IJi1~,ir~'~
S1 i iJCi; _•~i : t
CITY STATE
SECURED PARTY iLas~ Name Fus! a Pe~sonl I UPOATE ~
NAME FIRST A~;SERICAN SANR OF MARTIN COUNTY
2a P. 0. BOX 846 i
MAILING ADDRESS
AUDIT
' ciTr P~M ~ITY STATE FL. ~ 34990 i
;
~
i MUL7iP~E SECURED PARTY ~IF ANYi ILi3t N~me FnS' a Pereor~ i VALIpAT10N IHFOAMATION •
I NAME ~
i
! 2E ~
~ MAIUNG ADDFiESS
s
~ CITV STATE I
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3. 'n~s siaierr+e~t ~ete~s ±o ony~r,~i F;rancirp staterr~a~t Dea~~np a~ie NumOl~ 742346 a~ar~ieaw~tn
E CLERK OF THE CIRCUIT CT OF FT. PIERCE ThlOnOm~;w„~,~,co~ JANUARY 16, ,9 $6
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' 4. Co^t~nua!~u~ Tne onp~nat t~na~c~nfl eu;ement oetwaen ~ne ~ore9o~nfl Debtonst and Sscu•e~ Panyl~esl Deannp f~ie r.w++Der snown aDOre ~s s~~~~ e~~ect~ve
~ 5. ~Te~mmat~On SecweC Dany no ~or.qer cia:ms a secunty ~~terest u~0er tne hnanuny~ statement Dsa.~np hie ncmper snown above
~ V. . Part~ai $Om! O! $CCUr~ pirty 5 r~9nts u~0e. !ne f~nanu~p S'atement ha.e been ass~p~eo to tne ass~y~ee wnose name ana aedress are SEt fOrt~ ~n
6 ASS~qnm@c! item i i A tl25CnpbC~ O~ ~~E CC'~IatB~i! SUOjlC! fq th! 2SS~pnmem ~s aUO set fcnn ~n icem n
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[ FW~ A!: of Seco~e0 Party~s ngnts unee~ tne F~nananq Statemem nave Dl2~ d55,Q~Ed [O I~e ass~9nee wnose name ano aotlress are set ~Y~h
~ A35~~^T2~t in Itlm 1/
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a. A^ e~oTe~t F~nanc:ny Sta'eme~t Dea~~r,fl f ie n„r.,per s'~own aDnve ~s aT.endad as ser rortn m i;em t i S~gna!•.;re ot peocor ~eQwrp~ at Item i~ ;,n,z;s
~ ~ ame^d~*.e~t changes o!+~y name o~ address ct e~tne~ oar,y f
5
~ 9. . Re~ease Secwed Darty reteases oniy !~e conate~ai OeSCnUetl ~n i!em ~ 1 ~rem ~t1@ hn3n~in9 St3!BmEnt C2d'~~(j +~12 ~UmDE: S~Oi1Yn aDGr@
~ ~ Q. Cneck rrue An tlxumentary stamp taxes due and paraDie o~ tu Deccme due a~d Ga~abie Dursua~i !o Cnapte~ 201 22. F S ha+e Dee~ Ca~C
~ ~ i~ mo~e space ~s ~eo~~red atbcn add~r.o~ai sneets 8':
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12. No of ~oo~ncna! S~eets ~4. SIGNATURE~S) Of DEBTORIS) Necessary On!y For
_ ~ C~esemed Amen~ment See Item 8
4
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~ 13. Retum Gopy to
~ """"E FIRST At:ERICAN BANK OF M.ARTIN COUNTY
t= r~ ~~J. NIlTUREISI OF SE HEU PARTY(IE OH AS$iGNEE
~ ADDRESS P~ BOX 846 Q¦
103U SW MARTIN DOWNS BLVD. aGE ~ ~
r IGITV ~
PALM CITY I~
STATE Z~~ COQE
FLORIDA 34990 ~~OL J. D VICE PRESIDENT
STANDARD FORM - FORM UCC•3 /pC~oreODySecreUryofS~ate.5tateolFMnda
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