The URL can be used to link to this page

Home My WebLink About01-2571 PARTIES )ebtor name (last~ name first if individual) and mailin9 address: SEJ~.C GROUP LLC M~iANICSB~. PA ~7055~7 F~ DeMor name (last name firs~ if ~n~ivi~ual) ~n6 mailing address: Debtor name (last name first if individual) and mailing address: fa lb Secured Party(les) names(s) (last name first if indNidual) and address for security interest information: PATTERSON DENTAL SUPPLY INC 1031 MENDOTA HTS ROAD ST PAUL, MN 55120 Assignee(a) of Secured Patty name(s) (last ,ame first if individual) end address for security interest information: FINANCING STATEMENT U,iform Commercial Code Form UCC-I IMPORTAN'i'-PIeese read instructions on reverse side of page 4 before completing Filing No, (stamped by filing officer): Date. Time. Filing Office (stamped by filing officer): :, This Flouncing Stateme.t is presented ~er f,hn§ pursuan'~'~l ~'~l_l~]]~0~lmerc,al Code, and is to be filed with the (check applicable hex): ~ Secre~ry of the Commonwealth. ~othonotary of CUMBERLAND County. ~ real estate records of County. Number of Additional Sheets (if any): Optional Special Identification (Max. 10 characters): COLLATERAL Identify collateral by item and/or type: SEE SCHEDULE A, INVOICE [~O 1143465, DATED 4.17.01 2a Special Types of Parties (check if applicable): E] 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 flied with only the Secured Party's signature to perfect a security interest in collateral (check applicable box(es))- a. (~ acquired after e change of name, identity or corporate structure of the De~t~r. b. E3 as to which the filing has lapsed. c. already subject to a security interest in another county in Pennsy[vama- [~when the collateral was moved tn this ceonty. ~when the Debtor's residence er p[aoe of bnsiness was moved to · is coumy. d. already sabiect to a security inmrest in another jurisdiction- ~when the cogateral was moved to Pennsylvania. E]when the Debtor's location was moved m Pennsylvania. e. [~ which is proceeds of the cogatera{ 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) (required only if box(esl is checked above): E:] (check only if desired) Products of the collateral ore also covered. 9 Identify related real estate, if applicable: The collateral is, or includes (check appropriate box(es))- a. E~ crops growing or to be grown un - b. [-1 goods which are or are to become fixtures on - c. ~ minerals or the like (including Qd and gas) as extracted on - d. E] accounts resulting from the sale of minerals or the like (including oil and gas) at the wellhead or minehead off - the following real estate: Street Address: Described at: Book of (check one} ~ Oeeds [~ 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): lb RETURN RECEIPT TO: PATTERSON DENTAL SUPPLY INC 1031 MENDOTA HTS ROAD ST PAUL, MN 55120 10 11 ATTN; CINDY GILES NOTE - This page will not be returned by the Department of State, (1) FILING OFFICE ORIGINAL 12 SO - ) STORE: T~ MFP( ! FI~!/A WAY :'~ ~iI'IFI'i~C :fi! R~;, PR 17055-0000 TEL: ACCOUNT TYPE SUBTOTAL I SECURED I:IAR 1Y PHILRDEI.[~ I'F~ 109 CHEI. SEF'I Pt{R I,i:'? B001'IIWYN, PR 9, Eli ! ;o~', 610 497-1ll50 REMARKS NUMERICAL COPY PATTERSON SCLD TC ~EJAC (;R!ll:' LLC HECHflMICSBURG , DEPARTMENT C1:43 ~Onl~R~ SNIPPED~' ROEC UNIT PRICE Thank you GUSTOME R # PURCHASE ORDFR # I "'"'"' I FREIGHT (12) Shipped Via: AMOUNT CODES F'ROF T-Taxable CODES; P-Previous Back Order NO CREDIT ISSUED WITHOUT INVOICE NUMBER AND DATE F-1A3/20094 SCHEDULE A RIlACHMENI I0 UCC I N V 0 I C E 1143465 SECDRED PARTY ' PHILADELPHi'A B R AItC 1! STORE CUSTOMER # WAY 109 CHELSEA PRRKYAY G91520 ~[f', PR 1'7055-0000 B00THWYN, Pf'l '!906.1 i305 PURCHASEORDER# TEL 610 49'1-6150 ACCOUNTTYPE ~I~¢N~XI~E9 5 0 I E C H P-~,~ ~ ,~ 0 0 0 0 0 04/]7/2001 PRICE AMOUNT CODE~ ~CRIP~ION UNIT UMIT 463i ~UO 6Z~4738 ~ 1 RDEC ~XI~ 4~31 DUO £1'02745 ! I AOEC U)Il 4631 C~027~6 SPECIAL FORMIC 6300 TR~CK HT BIg3893 SUEITOTAL NUMERICAL COPY STATE TAX (151 LOCAL TAX (15t Thank you NO CREDIT ISSUED WITHOUT INVOICE NUMBER AND DATE Shipped Via: PAGE : T-Taxable CODES: P-Previous Back O~er F-IA3/20094 SOL ) ., . t~ ( ~ I[j) [ STORE: TO 2 I1H~':~ ! PLASH WAY il ~:LIAHI,:t 8 JRt;, PA 17055-0000 TEL I)EPAR 'MENT ACCOUNT TYPE 0 i :43 IfEM ~ O. O~DERE~ ~ ~PT~ SECURED ~ A R 1 Y 114346!!, UNIT PRICE cusrOMER¢ ~ .:, Z 0 [ ] h PURCHASEORDER# TECH 04/1 AMOUNT SUBTOTAL REMARK~ NUMERICAL COPY fll3E~: ~300 TR~¢K MT H~i) CtDiTiI I sTATETA (15 L ALTAX(15) D/F/P(18) I FREIGHT(12) I Ship~ed Via: CODES: Thank you NO CREDITISSUEDWITHOUTINVOICE NUMBER AND DATE SCHEDULE A PATTERSON ,0 DEN,. --AL UP INC SECURED PRRTY r;/~'lo~ P~¥ I N ~ O I C E SOLD SIT,AC GROUP [LC STO~: PHILADELPHIA BRANCH To 2 MARK['T PLAZA WAY ~09 CHELSEA PARKWAY HI~CIlANICSBURG, PA 17055~-0000 BOOTHWYN, PA ~9061 ~305 TEL 610 497-6150 DEPARTMENT ACCOUNT TYPE ~&~ ~E950 t E C H 43 ADEC STDQL t622 HSSI~tANT HADR§HR C19803A It ~DEC S'fg t' 0 1622 ASSISTANI UNIT PRICE TOTAL P R G tt T-Taxable P Previous Back Order F-lA3/20094 CODES 1143~65 CUSTOMER # 691520-.1.16 PURCHASE ORDER # I:i~#::00000 04/1. Z/2001 AMOUNT CODES I ADEC CHAIR COHP CASCADE UPHOLS ADEC CHAIR COMP CASCADE UPHOLS MADROHA+ SUBTOTAL REMARKS 1! ADEC CHAIR i HADRONR+ STATETAX(15)ILOCALTAX(15) CASCADE UPHOL. S D/F/P(18) Shipped Via FREIGHT(12) I TOTAL PAGE : Thank you T-Taxable NUMERICAL COPY NO CREDIT ISSUED WITHOUT INVOICE NUMBER AND DATE CODES:F-1A3/20094P-Previ°usBackOrder uPP~ ¥ c SqCUR!!D :'AR'tY SOLD SI~I at GROUP I.I.C STORE PlllLAI)E L PH! TO 7 HARKE1 PLAZA WRY 109 HECHRHICSBUR6, PA 1.7055-0000 BUOIHI~YN, DEPARTMENT ACCOUNT ~PE NO. OR.RED SHIPPED DESCRIPTION UNIT ~ ~ AOEC CHAIR COMP CASCADE UPH01S HADROIIR+ , REHOIE : ~4253/300765 ~: RE:MOlE i,t231/3o0741 [ ( [' 1143465 0,4/:17/2001 PRICE AMOUNT SUBTOTAL REMARKS NUMERICAL COPY tPORTER COAH SYS 24 BUT'rOII 3575/t849/13408/134 gT010218i/RJJ004354 / J STATE TAX (i5) I LOCAL TAX (15) J J D/F/P (18) Ship~d Via: Thank you NO CREDIT ISSUED WITHOUT INVOICE NUMBER AND DATE S C tt if D il L }' A HTTOCAMENI TO UCC FREIGHT(12) I TOTAL PATI'ERSON ? , SOLD ~5t JflC GROUP ti c STORE PllikADEt. PHl'll URItflCA TO 2 MARKET PLAZA WAY 109 CIIELSEfl PRRKWAY MECMANICSBURG, PR 11055-0000 B00EHWYN, PA /.906] ~ TEL 61.0 497-6150 DEPARTMENT ACCOU"T WPE ~ ~dJ 5 0 09:43 ~E~ s.~~' ' A O E C INVOICE DESCRIPTION UNIT PRICE H1SC GOLD COUPLER T Taxable CODES: P-Previous Back Order F-IA3/20094 11.43465 CUSTOMER # 69.L520-:116 PURCHASE ORDER # CODES [ECH [~1~#: 00000 04/17/2001 AMOUNT CODE~ SUBTOTAL REMARKS NUMERICAL COPY JSTATE TAX (15) LOCAL TAX (15)1 I D/F/P (18) Shlo~ed Via: Thank you FREIGHT (12) I TOTAL PAGE T-Taxable NO CREDIT ISSUED WITHOUT INVOICE NUMBER AND DATE CODES: P-Previous Back Order F-1 A3 / 20094