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HomeMy WebLinkAbout01-0692 PARTIES Debtor name (last name first if individual) and mailing address: Psychiatric Associates of Central Pennsylvania, P.C. 20 Erford Road, Suite 101 Lemoyne, Pa. 17043 Debtor name (last name first if individual) and mailing address: Debtor name (last ,nme first if individual) and mailing address: lb Secured Party(les) narae(s) (last name first if individual) and address for security interest i,fnrmatin,: Pennsylvania State Bank 2148 Market Street P.O. Box 487 C~mp Mi 11, P~. 17001-0487 2 Assignee(s) of Secured Party name(s) (last name first if individuM) and address for security interest information: 2a Special Types of Parties (cbeck if applicable): E~] The terms "Debtor" and "Secured Party" mean "Lessee" and "Lessor." m~Pectively. [~} The terms "Debtor" and "Secured Party" mean "Consignee" and "Consignor," respectively, [] Debtor is n Transmitting Utility. 3 SECURED PARTY SIGNATURE(S) Yhis statement is filed with only the Secured Party's signature to perfect e security interest in colleterer [check applicable box(es)) -- a. [] acquired after a change of name, identity or corporate structure of the Debtor. b.~ as to which the filing has lapsed. c. already subject to a security interest in another coua~ in Pennsy~vania-- [~ when the collateral was moved to this county. [~3 when the Debtor's residence or plane of business was moved to this d. already subject to a security interest in another jurisdlction-- [] when the collateral was moved to Pennsylvania. [] when the Debtor's location was moved to Pennsylvania. e. [] which is proceeds of the collateral described in block 9, in which a securityinterest was previously perfected (also describe proceeds in b~ock 9, if purchased with cash proceeds and not adequately described on the original financing statemeet). Secured ftarty Si~ature(s) (required only if box(es) is checked abovel: P~nia State Bank 4 FINANCING STATEMENT Uniform Commercial Code Form UCC-! IMPORTANT -- Please read instructions on reverse side of page 4 before completing Filing No. (stamped by filing officer): Date, Time, Filing Office (stamped by filing officer): Th s ~ina'nc ng Statement is presented for filing pursue nt to theL~iI~ml Co ~ m e~-cia f Co~'y~ h dJ~ he filed with the (check applicabte box): ~ Secretary of the Commonwealth ~ Prothonotary of CHmh~rl ~nd Count. ~ real estate records of County. Nurahar of Additional Sheeb (if any): Optional Special Identification (Max. 20 characters): COLLATERAL Identify collateral by item and/ar type: All inventory, accounts, equipment and general intangibles; whether any of the foregoing is owned now or acquired later; all accessions, additionsr replacements, and substitutions relating to any of the foregoing; all records of any kind relating to any of the foregoing; all proceeds relating to any of the foregoing (including insurance, ~eneral intangibles and other accounts proceeds). ~ [check only if desired) Products of the collateral are also covered. 9 Identify related mai estate, if applicable: The collateral is. or includes (check appropriate box{es)) -- a. [] crops growing er to be grown on -- b. Fq goods which are or are to become fixtures on -- c. [] minerals or the like (including oil and gas) as extracted on -- d. [] acc~untsresu~tingfr~mthes~e~fraineraIs~rthe~ike(inc~edin~i~andgas~atthewe~hnad~r minehead on -- the followin£ real estate: Street Address: Described at: Book__ of (check one) [] Deeds [] Mortgages, at Page(s) __ , for __ County. Uniform Parcel ~denfifier__ [] Described on Additional Sheet, Name of record owner (required only if no Debtor has an interest of record): Debtor Signature(s): DEBTOR SIGNATURE(S) I0 lb RETURN RECEIPT TO: Pennsylvania State Bank 2148 Market Street P.O. Box 487 Camp Hill, Pa. 17001-0487 11 12 IF THE FILING tS WITH THE DEPARTMENT OF STATE, SEND ONLY THIS PAGE.