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HomeMy WebLinkAbout01-0877 PARTIES Debtor name (last name first if individual) and mailing address: ANDREW BINGAMAN 261-4 RIDGE HILL ROAD MEC~ICSBURG, PA 17055 Debtor name (Fast name first if individual) and mailing address: Oebtor name (last name first if individual) and mailing address: Secured Foray(ice) name(s) (last name first if individual) and address for security interest information: AMERICAN GENERAL CONS. DISC ODMPANY 6 S. HANOVER STREET CARLISLE, PA 17013 ~signee(a) of Secured Party name(s) (last name first if individual) and address for security interest information: lb FINANCING STATEMENT Uniform Commercial Code Form UCC-1 IMPORTANT · Please read inalructio~s on reveme side of page 4 More comMeUn~ Rling No, (stamped by filing officer): D~e, Time, Fi/in~ Office (stamped by filing officer): This F~-naecing Statement is presented for filing pursuant t~Unifor~Dommerc~ Code, and ia to be filed with the (check applicable box): .-' c: .. : _! [] Secretary of the Commonwealth ---~ "~ 2,: ~] Prothonotary of CU~ERLA~D '< '? -" County. [] real estate records of County. 6 Number of Additional Sheets (if any): 7 Optional Sp~ial Idenfifica#on (Max. 10 characters): 8 COLLATERAL Identify coflateral by item and/or type: 2000 kAWASAKI JETSKI - VIN# KAW40711H900;MAKE JH1200A2 MODEL- JH1200A2 Special Types of ~tties (check if applicable): [] The terms "Debtor" and "Secured Party" mean "Lessee" and "Lessor," respectively. [] The terms "Debtor" and "Secured Party" mean "Consignee" and "Consignor," respectively. [] Debtor is a Transmitting Utility. 3 SECURED PARTY SIGNATURE(S) This statement is filed with only the Secured Parly's signature to perfect a security interest in collateral (check applicable box(es)) - a. [] acquired after a change of name, identity or corporate structure of the Debtor. ~. [] as to which the filing has rasped. :. already subject to a security interest in another county in Pennsylvania - [] when the collateral was moved to this county. [] when the Debtor's residence or place of business was moved to this county. L already subiect to a security interest in another jurisdiction [] 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 security interest was previously perfected (also describe proceeds in block 9, if purchased with cash proceeds and not adequately described on the original financing statement). Secured Party Si~ature(a) (required only if box(es) is check above}: 4 ~NOARD FORM - FORM UCC-1 proved by Secretary of CommonWealth of Pennsylvania [] (check only if desired) Products of the collateral are also covered. 9 IdenUfy related real estate, if applicable: The collateral is, or includes {cfiesk appropriate box(es) - a. [] crops growing or to be grown on * b. [] goods which are or are to become fixtures on - c. [] minerals or the like (including oil and gas) as extracted on - - d. [] accounts resulting from the sale of minerals or the tike (including oil and gas) at the wellhead or minehead on - the following reel estate: Street Address: Described at: Book __ of (check one) [] Deeds [--]Mortgages, at Page(s) __ for County. Uniform Parcel Identifier [] Described on Additional Sheet. Name of record owner (required only if no Debtor has an interest of record): OEBTOR SIGNATURE(S) 10 lb RETURN RECEIPT TO: AMERICAN GENERAL CX3NSUMER DISCOUNT C~ANY 6 SC~ HANOVER STREET CARLISLE, PA 17013 11 12 INSTRUCTIONS 1. PLEASE TYPE OR PRINT all information in black. 2. FOR FIUNGS vVFrH '~-tE DEPAFCrMENT OF STATE YOU MUST USE THIS FORM or a standard form approved by the Secretary of the Commonwealth. If additional sheets are needed due to limited space on this form, use additional 8 1/2 X 11 inch sheets. Be sure to indicate the number of sheets (if any) in block 7. If the security agreement [tself is filed as the financing statement, ~ must be filed with this form propedy completed and with conformed signatures (such as '/si(name of signer)'). THIS FORM MAY NOT BE ACCEPTABLE FOR FILING IN ALL COUNTIES. PLEASE CHECK VVI3'H THE PROTHONOTARY OF THE COUNTY WITH REGARD TO [TS ACCEPTABILITY AND USE. 3. COMPLI:II: THE FORM CAREFULLY. Follow any instructions provided, and only check boxes that apply to the transaction or this filing. List only 1 debtor name per block 1, la & lb. Be sure to leave block 5 blank, for completion by the filing officer. To help you identify this filing, a special identification number or letter code of up to 10 characters may be entered in block 8. Any such identification number or letter code is entirely optional, and is only for the convenience of the filer. This number or letter code will appear on the receipt for this form that you will receive from the filing office of the Department of State. 4. FLUNG FEES must be paid at the time of filing. The fee for filing this form with one (1) debtor name with the Department of State is $12.00. For each additional name listed on the UCC-1 form include an additional $12.00 with the filing fee. There is no extra charge for additional sheets filed with this form. For filings with the Department of State, make your check payable to 'PA Department of State'. Separate checks are required for each filing. Local filings are to be made with the appropriate county office. Please check with the Prothonotary of each county with regard to local filing instructions and fees. 5. MAIL OR DELIVER this form to the appropriate state and/or county office(s) for filing. Be sure to indicate the filing office in block 6, and remember to include your check to cover required filing fees, Filings with the Department of State are to be addressed to 'Uniform Commercial Code, Department of State, Harrisburg, PA 17120', You are advised to keep a copy of this Form UCC-1 for your own records, 6. A RECEIPT for this form, bearing the date time, filing number, and any special identification number or letter code entered in block 8, will be returned to you by the Department of State. The receipt for this form will be mailed to the name and address listed in block 12.