HomeMy WebLinkAbout01-2405 PARTIES
D'~btor name (last oa,m,e first if individual) and mailing address:
Debtor name (last uame first if individual) and mailing address:
Debtor name (last name first if individual) add mading address:
FINANCING STATEMENT
Uniform Commercial Code Form UCC-1
IMPORTANT-Please read instructions off
reverse side, of page 4 before completing
Filinll No. (stamped by filing officer): Date, Tima;~Filin~f, fip (stamped by filing officer
P~-NNSYLVAN~
This Financing Statement is presented for filing pursuant to the U~if~rm bommerua Code,
and is to be filed with the (check applicahle box)
~/D decretary of the Co~onwealth.( '-~ ~,~i" ~/~ ~ ~/
fD real estate records of County.
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Secured Party(les) names(s) (last name first if individual) and address
for secdr!tY interest informatirm: -. ,,
l ,/i,", t" (, ,/.;.,-/
~iDnee(s) Qf Secured Pa~ ~e(s) (hast name first if individual) and
address for security interest inform8tiom
Number of Additional Sheets (if any):
Optional Special Identification (Max, fO characters ~
COLLATERAL
Identify collateral by item and/or type:
2a
Special Types of Parties (check if applicable):
~ The terms "Debtor" and "Secured Party" mean "Lessee" and "Lessor,"
respectively.
[] The terms "Debtor" and "Secured Party" mean "Consignee" and
"Consignor," respectively.
[] Debtor is a Transmitting Utility
3
SECURED PARTY SIGNATURE(S)
This statement is filed with only the Secured Party's signature to perfect
a security interest in collateral (check applicable box(es))-
a. [] acquired after a change of name, identity or corporate structure of
the Debtor
b. E~ as to which the filing has lapsed,
c. aLready subject to a security interest in another county in Pennsylvania
[]when the coLLateral was moved to this county.
E]wheo the Debtor's residence or place of business was moved to
this county.
d. already subject to a security interest in another jurisdiction-
[]when the collateral was moved to Pennsylvania
[]when the Debtor's location was moved to Pennsylvania.
~42~' ~hich is proceeds of the collateral described in block 9, in which a
'~' security interest was previously perfected (also describe proceeds in
block 9, if purchased with cash proceeds and not adequately
described on the original financing statement).
Secured Party Signature(s)
(reqaired only if box(es) is checked above):
STANDARD ~ORM - FORM UCC-1 (7-89)
Approved by Secretary or Commonwealth of Pennsylvania
[] (check only if desired) Products of the cogateral are also covered.
Identify related real estate, if applicable: The colbteral is, or incIodes tcheck opprapriate box(es))-
a [] crops growing or to be grown on -
b. [:3 goods which are or are to become fixtures on -
c. [] minerals or the like (including oil and gas) as extracted an -
d. [] accounts resultin9 from the sale of minerals or the like (including od and gas) at the welihea
minehead on -
the fallowing real estate:
Street Address:
Described at: Book ____ of (check one) [] Deeds [] Mortgages, at Page(s)
for County. Uniform Parcel Identifier
[] Described an Additional Sheet
Name of record owner (required on1¥ if no Debtor has an interest of record):
DEBTOR SIGNATURE(S)
Debtor Signature(s): /
fa
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RETURN RECEIPT TO:
~OTE - Bo not s~nd this page tot~e Department of State.
(2) FILING OFFICE ACKNOWLEDGEMENT - COUNTY ONLY