HomeMy WebLinkAbout01-0612Oebt~ ~ -~ (last name fi~ if indMfiea~ and melting address:
A. Bailey Wood DDS
207 Sogth 32nd Street
Camp Hill, PA 17011
Debtor name (last name first if individual} and mailing address:
NeMor name (last name first if individual) and mailing address:
FINANCING STATEMENT
Ufllfofla Commercial Code Form UCC-1
~/~---C,~ ~ IMPORTANT -- Please read IflstruotleBI OD
w
reverse side of page 4 bofere completing
Filing Ne. (stamped by filing officer): Date, Time, Filing 0i~ {stamped by filing officer)
This Rnnaelq Stofmlnat is presented for filing pumuant to the Uniform Commemisl Code, and is to be filed
with the (check applicable box):
1 a [] Secretary of the Commeflwss~.
Prothonotary of
.tutu ,.,e o, Curm bea Io,, d
R~mi~ of ,fidd#lonal lboof~ (if
Optional lpl~lll IdnaflflnaUna (Max. 10 characters): AGRM ] ~¢ 20OO26833
COU. ATERAL
lb Idebtify collateral by item and/or type:
Senarsd P~(Ina) name(s) (last name first if individual) and address for
security interest information:
CITICORP VENDOR FINANCE, INC,
700 EAST GATE DRIVE
MT, LAUREL, NJ 08054
2
Aaofgnna(I) of Sneered Party name(s) (last name flint if individual) and address
for eecudty interest information:
2a
~JM '1~ of Pa~lna (check if applicable):
The terms "Debtor" and "Secured Party" mean "Lessee" and "Lessor,"
respebtively.
[] The terms "Dchtur' and "Secured Party" mean "Consignee" and
"Consignor," respectively.
[] Debtor is a TransmitUng Ufility.
3
County.
County. 6
7
8
SEE EXHIBIT A
~(~k co~ if d~ir~) P~uc~ of ~e collateral are al~ cover~
I~ ~ ~1 ~, fi ~plico~is. The ~lisleml is, or J~clu~es (~ ~ k~)) -
Ne~d~ M: Book of (ch~k one) ~ ~s ~ Mo~gages, at Page(s)
SECURED PARTY SIQNATURE(S)
This statement is flied wlta only the Secured Pady's signature to perfect a
secudty interest in collateral (check applicable Sex(an))--
a. [] anqeired ~er a ehnage of name, Ideotlly ar narperate structure of the Debtor Signature(s):
Debtor.
b. [] as to which the filing has lapsed.
c. already s~fiject to a sanurity interest in another county in Pennsylvania-- 1 ~
[] when the eoftutursl was moved to this county.
/~/
[] when the Nebtur's faofdnaee or place of business wna moved to this
county, la
d. already subject ~ a secodty ibterest in another Jodediofta~ --
Secured PaRy Signature(e):
(required only if box(es) is checked above):
DEBTOR SIGNATURE(S)
A. Bailey Wood ODS
1
RETURN RECEIPT TO:
CITICORP VENDOR FINANCE, INC.
700 EAST GATE DRIVE
MT. LAUREL, NJ 08054
FILING OFFICE ORIGINAL
g01~ -- Thll papa will eot be retunled by the Delreflmeot of State.
IF THE FILING IS WITH THE DEPARTMENT OF STATE, SEND ONLY THIS PAGE.
c t capital.'.
EXHIBIT A
To the UCC-I Financing Statement
Debtor:
A. Bailey l,/ood DDS
Secured Party: Citicorp Vendor Finance, Inc. 700 East Gate Drive
Mt. Laurel, New Jersey 08054
"Collateral" means all of Debtor's assets, including without limitation the following: the Debtor's
now existing or hereafter acquired or arising (i) Inventory, including all items held for sale or lease to
third parties, and all returned and repossessed items; (ii) Accounts; (iii) General Intangibles, Chattel
Paper, Goods, and Instruments, including all leases oflnventory and Equipment and all rentals and other
amounts payable thereunder; (iv) Documents of Title; (v) Equipment and all accessions, accessories, parts
affixed to or used in connection with any such Equipment; (vi) any balance or share belonging to the
Debtor of any deposit, agency or other account with any bank and any other amounts which may be
owing from time to time by any bank to the Debtor;, and (vii) all property of any nature whatsoever of the
Debtor now or hereafter in the possession of or assigned or hypothecated to the Secared Pan'y, together
with all products and Proceeds (including insurance Proceeds) of any of the foregoing.
"Inventory," "Accounts," "Chattel Paper", "Goods", "Documents of Title," "Equipment,"
"Instruments," "General Intangibles" and "Proceeds" shall have the meanings assigned to them under the
Uniform Commercial Code as in effect in the State of New Jersey.