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:
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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
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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)
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RETURN RECEIPT TO:
Pennsylvania State Bank
2148 Market Street
P.O. Box 487
Camp Hill, Pa. 17001-0487
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IF THE FILING tS WITH THE DEPARTMENT OF STATE, SEND ONLY THIS PAGE.