HomeMy WebLinkAbout01-16352815429-4t-2 PARTIES 90639 COASTAL.2 - '
Debtor name (last name first if individual) and mailing address:
Susquehanna Valley Pain Management, P.C.
6271 Ryecroff Drive
Harrisburg, PA 17111
Debtor Name (last name first if individual) and mailing address:
D~btor name (last name first if indivfdual) and mailing address:
Secured Party(les) names(s) (last name flgst If Individual) and
rs u ' Interestl formation:
5310 N.W. 33rd Ave.
Suite 114
Ft. Lauderdale, FL 33309
59-2003553
Assignee(s) of Secu~d Party name(s) (last name first If
individual} and address for security interest information:
FINANCING STATEMENT
Uniform Commercial Code Form UCC-1
IMPORTANT-Please read instructions on
reverse side of page 4 before completing
FilinG~No. (stamped by filing officer): Date, Time, ~ o~ice (s~amp~ ~ filin~o~cer):
County
This Financing Statement is presented for filing pursuant to the Uniform Commercial Code,
and is to be filed with the (check applicable box):
[] Secretary of the Commonwealth. _ .__
[~ Prothonotary of _ t~,)M~ ~'~D C~
[] real estate records of
5
lb Number of Additional Sheets (If any): 7
Optional Special Identification (Max. tO Characters): 281 5429 8
COLLATERAL
Identify collateral by item and/or type:
Equipment leased by Lessee pursuant to Lease Agreement #8303 dated
03/11/01 between Coastal Leasing, Inc. as Lessor and Susquehanna
Valley Pain Management, P.C. Lessee, insurance thereon and proceeds
thereof as more fully described as - eEC 9000 Medical C-Arm
Remanufactured and Refurbished by ISI
~ecial Types of Parties (check if applicable):
Debtor is a Transmllbn9 Utili[y.
SECURED PARTY SIGNATURE(S)
Secured Party Signature(s)
(required only if box(es) is checked above):
Coastal Leasing, Inc.
ATTORNEY'IN'FA L CflOi
STANDARD FORM - FORM UCC-1
Approved by Secretary of Commonwealth of Pennsylvania
the following real estate:
Street Address:
Described at: Book of (check one)[~ needs [] 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):
DEBTOR SIGNATURE(S)
Debtor Signature{s):
Susquehanna Valley Pain Management, P.C.
RETURN RECEIPT TO:
UCC Direct Services
P.O. Box 29071
Glendale
CA P~o.~ (800) 331-3282
91209-9071 F~ (818) 662'4141
HAROLD CASTILLO
FILING OFFICE ORIGINAL ~ /o~/W