HomeMy WebLinkAbout01-1459 PARTIES
CE BTOR name (Last name first if Individual) and malting address:
SedJack, MD, Jeffrey D.
220 Wilson Street
Carlisle, PA 17013
DEBTOR name (Last name first if Individual)and mailing address:
DEBTOR name (Last name first if Individual)~tnd mailing address:
SECURED PARTY(les) name(s) (last name first if individual) and adQress for
security inlerest i~ formation:
PENNSYLVANIA STATE BANK
1 North Hanover Street
Carlisle, PA 17013
2
ASSIGNEE(S) OF SECURED PARTY neme(s) (last name first if individual) and
address fc~ security interest information;
FINANCING STATEMENT
UNIFORM COMMERCIAL CODE FORM UCC-I
FILING NO. (staml~e d by filing officer); DATE. TIME. FJLING OFFICE
~ ] -- / ~_.~ (st~mpedbyfilingofficer)
COLLATERAL
See Attached Exhibit to UCC Financing Statement dated March 9, 2001.
SP CIAL TYPES OF PARTIES (Check if applicab~e);
Theterms'Oebtor"~nd'Secure0Party"mean~kessee"and'kessor',
respectively.
SECURED PARTY SIGNATURE(S)
THIS STATE MENT IS FiLE D W~TH ONLY THE SECURE D PARTY'S
S[G NATURE to perfect a security interest in collateral (check app]icable
box(es)) ~-
ACQUIRED AFTER A CHANGE OF NAME. IDENTITY OR
CORPORATE STRUCTURE of the Debtor.
c. already sublect to a security [r~t erest in ANOTHER COUNTY in Pennsylvania
[~ when the COLLATERAL WAS MOVEO to this county.
when the DEBTOR'S RESIDENCE OR PLACE OF BUSINESS
WAS MOVED to this county.
d. aJready subject fo a security interest in ANOTHER JURISDICTION --
] when the COLLATERAL WAS MOVED to Pent, sylVania.
WAS MOVED to Pennsylvania.
which is PROCEEDS of the collateral described in block
wl~ich a security interest was previously perfected (also describe
] (check only If desired) Products of the collateral are also
IDENTIFY RELATE D REAL ESTATE. it appllca, ble. The c olla ter~_ ~rl incluQes (chec~ ~prl:te
DEBTOR SIGNATURE(S)
Jeffrey D. Sedlack, M~~'''~'''''~
SECURED PARTY SIGNATURE
(requireQ Only box es s checked above):
RETURN RECErPT TO:
PENNSYLVANIA STATE BANK
2148 Market Street
P.O. Box 487
Camp Hill, PA 17001-0487
STANDARD FORM - FORM UCC-1 (7-89)
Approved by the Secretary of the Commonwealth of Pennsylvania
FILING OFFICE ACKNOWLEDGEMENT - County only.
NOTE - This page will not be returned by the Department of State,
EXHIBIT TO UCC-1 FINANCING STATEMENT
DEBTOR:
Sedlack, MD, Jeffrey D.
MAILING ADDRESS:
220 Wilson Street, Carlisle, PA 17013
March 9, 2001
COLLATERAL DESCRIPTION:
All Accounts, Equipment, General Intangibles and Fixtures; whether any of the foregoing Is owned now or acquired later; all accessions,
additions, replacements, and substitutions relating Io any of the foregoing; all records of any kind relating to any of lhe foregoing; all proceeds
relating to any of the foregoing (including insurance, general intangibles and other accounts proceeds)..
This Financing Statement is to be recorded In the real estate records, Some or all of the collateral Is located on the following described real
estate:
This Exhibit is executed on the same date as the UCC--1 Financing Statement by PENNSYLVANIA STATE BANK and the undersigned.
Jeff~.ey D. Se;llsck, MD PE~INSYLVANIA STATE BANK
/ Signat~'~)~fJDebtor(s)~ By: Elc'~v ~
Signature(s) of Secured P~rty (ies)