HomeMy WebLinkAbout01-2869 PARTIES
DebtOr ~a~e ~ast name first if iadMduai) and mailing address:
Debtor aame (last name first if individual) and mailing address:
Debtor name 0ast name first if individual) and mailing address:
lb
Secured PartyDes) name(s) (last name hrst it individual) and address for security
interest information:
Assignee(s) of Secured Party name(s (last name first if individual) and address
fm security interest information:
FINANCING STATEMENT
Uniform Commercial Code Form UCC-I
IMPORTANT - Please read instructions on
reverse side of page 4 before completing
Filing No. (stamped by filing officer):
This Financing Statement is presented for filing pursuaut o ~lLl'r[ ~,~, a~d
with the (check applicable box):
~"Secretary of the Commonwealth.
~ real estate records of
Date, Time, Filing Offi~e~st~mped by filing officer)
Number of AddltlonaJ Sheets (if any):
Optional SpeciQI Identification (Max. 10 characters):
COLLATERAL
Identify collateral by item a~d/or type:
5
is to be filed
County
County
6
7
8
ga
Special Types of Parties (check if applicable):
[] The terms "Debtor" and "Secured Pmty" mean "Lessee" and "Lessor,"
respectively.
[] The terms "Debtor" and "Secured Party" mean "Consignee" a~d "Co~signor,'
respectively
[] Debtor is a Transmitting Utitity.
3
SECURED PARTY SIGNATURE(S)
This statement is filed with onJy the Secured Party's signature to perfect
a security ir~terest in collateral (check applicable box(es))
the Debtor
b. [] as to which the filing has lapsed.
e. '~ which 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 financiag statement).
(required only if box(es) is checked above):
[] (check only if desired) Products of the collateral are also covered,
Identify relaled re.I estute, if applicable: The collateral is, or includes (check appropriate box(es))
a, [] crops growing or to be grown on -
b. [] goods which are or are to become fixtures on -
c. [] minerals or the like (including oil and gas) as extracted on -
d. [] accounts resulting from the sale of minerals or the like (including oil and gas) at the wellbead or
minehead on
the following real estate:
Street Address:
Described at: Book of (check one) [] Deeds [] Mortgages, at Page(s)
for County Uniform Parcel Ideetgier
[] Described on Additional Sheet.
Name of record owner (required only if no Debtor has an interest of record):
~ DEBTOR SI/C~NATURE(S)
Debtor Signature(s)~ ? ) ,/-~ ...___.~.
lb
RETURN RECEIPT TO:
STANDARD FORM - FORM UCC 1
Approved by Secretary of Commonwealth of Pennsylvania
Members let Federal Credit Union
5000 Louise Drive, P.O. Box 40
Mechanicsburg, PA 17055
FILING OFFICE ORIGINAL-ORIGINAL
lO
12
l~aY-04-2001 FRI 10:40 ~qH ?IEMBERS IST CENTRAL FILE F~X ~0, 71770E~047 ?,
l}sla~,.~ Cmi~plt~ Center
-'~:'::: ............. ~ - ' : ~ ,, ~A ~; ;:~ '. '~' :'-' -~'" ~'~' ~''''~-'~ "~ ' ,{ -: -':>'['~'~i): ' -" :'-~---
IN~UflA~ AGAINST LJADILI~ FOR BODILY I~URY OR PflOPER~Y TITLE APPLICATION INFORMATION .
Oto~ ~C~-~ ........ ~ .-'~:~: t~:.~q~.,~ 1 ~ ........ ~ .........
.................................... ,
/ [ L~SS TOTAL CRedITS $ ~
................... ' -- -SUS-)O~ ~ '~' 5J~
.......................... ~ - ~"~"'- SALES TAX (If Not Included Above)
......................... -~--:,~
BA~NCE CARRIED TO DP rlOHAL EQUIPM~T [ ~ ff IS MUTUALLY UNDERgTOOD I'It~IIS ~EEI~T
~pflou o~q~ sa; CO~RNING CH~GES IN NET PAYOF~N I'~E-IN~ BE
FIn~ on the back of ~ls eo~r~t are agr~d to es pad of this
................... purchasl~ ~ a~ve d~ ~; the o~al ~[~nt
O~o Camping Cen~t .. ~ ../-