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2823122-41-2 PARTIES 92336 ALARIS FINANCING STATEMENT
Uniform Commercial Code Form UCC-I
Debtor name (last name first if individual) and mailing address: IMPORTANT-Please read instrUCtions on
HOLY SPIRIT HOSPITAL reverse side of page 4 before completing
:' l::J~tei~ .:'rime;'Fi~g:~'fi~ (stamped by filing officer):
_,~._~3 N. 21ST STREET Filing No. (stamped by filing officer): .
~,~PHILL,PA 17011 ' I,O? ..'.. '"-..' ".
'; ' ':
~'~... 1
Debtor Name (last name first if individual) and mailing address: - ' '* :".
C~ ;.,........ .....
~t,.,~i!...: *; ~*,'"~ ""¥: b; (':'/":: .~x ~".~.~
· ~ Y" .~;_' ~ . ~ ,,.
la This Financing Statement is presented for filing pursuant to the Uniform Commercial Code,
Debar name (last name first if individual) and mailing address: and is to be filed with the (check applicable box):
~ Secretary of the Commonwealth.
[--~ real estate records of County
6
' lb Number of Additional Sheets (if anY): ?
.
Secured Party(les) names(s) (last name first if Individual) and Optional Special Identification (Max. 10 Characters): _ 823
~ys~ems, i nc. Identify collateral by item and/or type:
10221 Wateridge Circle ONE PAGE OF SERIAL NUMBERS FAXED SEPERATELY.
S_an-~)iego, CA 92121-2733 2 COLLATERAL TOTAL IS' 5/EA. MODEL 7230B (SE 2CH PMP ADV FTR
133800335 120V NA) "IDA No." 40103008
Assignee(s) of Secured Party name(s) (last nM_me first if
individual) and address for security interest information:
2a
ecial Types of Parties (check if applicable):
The terms 'Debtor' and "Secured Party' mean 'Lessee' and "Lessor,"
respectively.
~-] (Check only if desired) Products of the collateral are also covered.
9
['-] The terms 'Debtor' and "Secured Party" mean 'Consignee" and
"Consignor," respectively, crops growing or to be grown on -
['"'] Debtor is a Transmitting Utility. LF-! goods which are or are to become fixtures on -
r'] minerals or the like (including oil and gas) as extracted on -
r'] accounts resulting from the sale of minerals or the like (including oil and gas) at the wellhead or
minehead on -
SECURED PARTY SIGNATURE(S)
This statement is filed with only the Secured Party's signature to perfect the following real estate:
a security interest in collateral (check applicable box(es))- Street Address:
a.r-] acquired after a change of name, identity or corporate structure of
the Debtor. Described at: Book__of (check one)F-'~ Deeds r--] Mortgages, at Page(s)
b. [-'-] as to which the filing has lapsed, for County. Uniform Parcel Identifier
I--I Described on Additional Sheet.
c. already subject to a security interest in another county in Pennsylvania
Name of record owner (required only if no debtor has an interest of record):
r -] when the collateral was moved to this county.
10
r --] when the Deetor's residence or place of business was moved to
this county. DEBTOR SIGNATURE(S)
d. already subject to a security interest in another jurisdiction- Debtor Signature(s):
E~] when the collateral was moved to Pennsylvania. HOLY SPIRIT HOSPITAL
r'-] when the Debtor's location was moved to Pennsylvania. 1
e.r--] which is proceeds of the collateral described in block 9, in which a
security interest was previously perfected (also describe proceeds in BAILEY
block 9, if purchased with cash proceeds and not adequately
described on the original financing statement). ATTORN EY-I N-FACT
lb 11
RETURN RECEIPT TO:
Secured Party Signature(s)
(required only if box(es) is checked above): UCC Direct Services -.-
P.O. Box 29071
ALARIS Medical Systems, Inc. Glendale
CA Phone (800) 331-3282
,~~j 91209-9071 Fa,, (8'8) 6§2-4141
ATTORNEY'IN'FAC~/'~"-'~"~"'" PAULCHOI , Prepa~~dw~thU~~D~rect~~~W~nd~ws~~CC~D~~~ct~~rvices~P~~~B~x2~~7~~G~enda~~~CA~~2~9-9~7~Te~(8~~)33~~3282 .12
STANDARD FORM - FORM UCC-1 (7-89) FILING OFFICE ORIGINAL '"
L Approved by Secretary of Commonwealth of Pennsylvania '.: ·