HomeMy WebLinkAbout01-1133PARTIES
Debtor narna (last name fi~ if individual) and mailing address:
Debtor name (last name first if individual) ;ad mailing address:
Secured Pirty(io~ name(s) (last name first if individual) and address for security
interes~ inferm~tbn:
Box 67
Robee~nia, PA 19551
Anaign~($) of Secured Pmly nan, s) (lest name first if in~vidu~1) and adc~ress
~r ~e~rity intarest inforr~:
Nor~
FINANCING STATEMENT
Uniform Commercial Code Form UCC-1
filing No. (stamped by firing o~cer): Date, Time, Filiog Offina (stambo~ :bY filing off~:
l~io Irrs~i~l Stotome~t is present~ for filing pursuant to the Uniform Commercial Cdde, and is to
be fi~l wi~ the (dnad~ ~p~Jnable box):
I"1 ~ estate reserds o~
Number of Additional Sheets (if any):
Optional Specbl Identification (Idax. 10 charscters):
COLLATERAL
Identlly oollatoral by item and/or type:
All invm~:ory, go~dl; and
now exi~Jng of
hereafter acquired by Debtor including the pror. eed~ of
the role thereof and replaoe~s therefor, ~ all
County.
County.
$
7
8
Spe~iaJ Types of Parties (check if applicable):
DThe terms 'Debtor' and 'Secured Part~' mean 'Lessee" and 'Lessor,'
[]The ~rns "Deb~x" and "Secured ~ mean 'Consignee' and "Consignor,"
[] Debtor is a Transm, it~ng Utility.
SECURED PARTY SIGNATURE(S)
This ~tatoment is filed with only the Se(tared Party's lignature to perfect a
seouf~ty interest in ~ollatoral (che~ appliuabie box(es)-
a. li a~uired after a change of name, idemityoreollmratestmc~ureofthe
Debfo~
b. [] astewhichthefllingheelap~ed.
c. alreddy sul~est fo a security ifltereet in another ~ounty in Pennsylvania -
[] when the collateral was moved fo this county.
[] whan the Debtor's reddence or place of business was moved to this
county,
d. already ssbject to a secudty intoreat in aeo4ber jurtadiotion -
B when the collateral w~ moved to Pennayk'ania.
when the Debtor's foc~ion was moved fo Pannsyivania.
e. [] which is pronaed$ of the so~terai desoribod in biock 9. inwhichasecu~ity
interest was previously perfected (aLso describe proceeds irt b~ock 9, if
purchased wi~ cash pmcedds and na~ adeflua~ly described on I~e or~ginaJ
financing statement).
Sanured Party Signature(e)
(required only if box(es) is cbeck~d above):
[] (check only ~f desired) Products of the collateral are also covered. 9
Identify related real estate, if appliuab~e: The collateral is, or includes (check approprLate box(es) -
a. [] crops growing or to be grown on -
b. [] gooclswhichareorarefobecomefixtureson-
c. [] minerals or the like (inalud[ng oil and gas) as exlracted on -
d. [] amcounte resulting from the sale of mlnerefo or the like (incJuding oil and gas) at the
wellhead or mineheed on -
the following reaJ estate:
Street Address:
Oescdbed at: Book of (che~ one) r-]De~s rlMortgages, atPage(s) ,
for C;ounty. Uniform Parcel I~etqlJfier
[] Oesslibed anAdditbnal SheeC
Name o! record ownar (required on~y if no Debtor has an interest of record):
DEBTOR SIGNATURE(S)
Debtp. r,Signature(s): /~ ~ ..
,
10
lb.
11
RETURN RECEIPT TO:
Thontas Teeter
A~.~ooia~ecl tNttole~4aler&, In~.
Box 67
Robe~xlia, PA 195151