HomeMy WebLinkAbout01-2392 PARTIES
[~bto~ name {last neree first if individual) and mailing add~ess:
Silver SpringAmbulance
and Reecue Aaeociation
12 Eleanor Drive
· New Kingstown, PA 17072
Deb~ name (last name firet if individual) and mailing address:
name (fast name first if individual) and meiling address:
lb
Secured pmlyiles name(s) bst name first ff ioolvidust and address lot sscu~ty
int~l informelie~
Commonwealth of Pennsylvania
PA Emergency Management Agency
Volunteer Loan Assistance Program
2605 Interstate Dr., Harrisburg, PA 17110 2
A~) of ':eom~d Party name(s) (last name fl~ ff individual) and address
FINANCING STATEMENT
Uniform Coqmercial Code Form UCC-1
MPORTANT-Please read instructions on
reverse side oF page 4 before comp eting
Filing No. (stamped by flin0 ofr~cer): Date~i~ ~jfif~9_4:~.~e (stamped by filir~ officer)
This FinQnclng ~ateenf is [Xesoot~ for fling pursuant t0~ Code, and Is to be flied
with the (chec~ applic~ble box):
[] Secretary of the Cornrncnw~th.
[] Prof~ of Cumberland
[] real 6stata records of
Number of Additional Sheets (it a~y):
Opfiona~ Special IdenTification (Max. 10 cheract~s~
COLLATERAL
Identify collateral by itGfll and/or tyDe;
2001 PL Custom Type II! Ambulance on Ford Chassis.
C~nty.
6
7
8
Specifications on file
2a
Speeiof Types of Parfie~ {check if applicable):
[] ~ trams "Oebtor" a~ "~ ~' ~ "LSS~" a~ "~r,"
m~ely.
~ ~ ~ "~' a~ "~ ~" ~n "C~s~" ~ ~o~r,"
r~.
~ ~ ~ a Tm~ ~1~.
3
SECURED PA~TY SIGNATURE(S)
Vehicle ID# 1FDXE45F41HA44005
[] (check naly if desired) Products of the collat~al are am covered.
klenti~y related mol e,tate, if applicable: ~e collateral is, or includes (check approFiate box(es)) -
a. [] ,crops growing or to be grown on -
b. [] ~ds which am or are to become fixtems o~ -
c. [] mlnen]b or the like (includin~ all and ~s) as extracted ~ -
d. [] accom~ resulting ~rom the sale ~f ml.erab or the like (including 0il and gas) at the wellhead or
reinei~ead o,~ -
Thb datemmw b filed with ody dm Seemed Pa~,'s signature to pprf~ the falk:~ing real e.~tata:
a sasndty interest in collatafal (check applicable b~x(es)) - .~re~ Address:
the Debbr.
b. [] as to which the filing hm la~ed.
c. already subject to a seoorify interest in another county in R~nsylvanis-
[] wh~l the trilateral wm mo~ed tO this C0OOty.
De~dbed at: BOOk Of (check ore) [] Deeds [] Moftgagas, at Paga(s)
for C~my. Un~ ~( ~r
~ ~i~ on ~al ~t
~ ~ mco~ ~ (r~uimd on~ ff ~ ~ has an inte~ of ~o~):
DEBTOR SIGNATURE(S)
[] m the ~ebloe'* re,~ide~e or place of bu~ine~ 'was ~d ~ ~bbr ~a~(s):Silver Spring Ambulance and Rescue Association
~ w~ ~ cdb~ ~ ~d ~ ~y~
~ wh~ ~ ~r'* ~c~ion ~ m~ ~ ~ la
e. ~ ~h ~ ~ of ~ ~rM ~i~ in b~k ~. in wh~h a
~ i~mt ~ ~ ~ (a~ ~f~ p~ds in lb
~ 9, ~ ~cha~ w~ ~ ~ and ~ ad~ua~ ~b~ R~RN R~EIPT T~
na ~ ~l ~i~ ~t). INTEROFFICE MAIL
S~d ~ Sig~mls)
(~uir~ ann if ~x(~) · c~c~d a~e):
PA EMERGENCY MANAGEMENT AGENCY
VOLUNTEER LOAN ASSISTANCE PROGRAM
2605INTERSTATE DRIVE
HARRISBURG, PA 17110
10
STANI~0 FORM - FORM UCC-1
Ai~ffoved by Sec~tary ~f C~mmonwssifh of Pennsylvania
(MAIL) 2605 INTERSTATE DR., HARRISBURG, PA 17110
12