HomeMy WebLinkAbout01-2931 PARTIES
DebtoF name (last name first it individual) and maibeg address:
Laughlin, Harry B.
812 York ¥iev Drive
Grantham, Pa 17027
Dobtor name (last name first if individual) and mailing address:
Debtor name (last name first if individua0 and mailing address:
lb
Secured Party(les) name(s) (last name tirst if individual) and address for
security interest information:
Northwest Consumer Discount Company
223 Penrose Place
Carlisle Pa 17013 2
Assignee(s) of Secured Party name(s) (last name first if individual} and address
for 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 bling oiticer): Date, Time, Filing Off ce (sf~ed,~g filing officer:
*. ....
Th sF UaRC ogStatement~s presen ed or mgpursuan o he Un ormC'~/.~,ar~d~ obe ed
with the (check applicable box):
[] Secretary of the Commonwealth.
~] Prothonotary of __ C'r--'herland __ ._ County
~ rea[ estate records of County
Number of Additional Sheets (d any): 7
Optional Special Identification (Max 10 characters(:
COLLATERAL
Identify collateral by item and/or type:
1.01 ct Diamond in Platinum Ring
2a
Special Types of Parties (check if applicable):
I--'1 The terms "Debtor" and "Secured Party" mean "Lessee" and "Lessor,"
respecbvely.
[] The terms "Debtor" and "Secured Party" mean "Consignee" and
"Consignor," respectively.
E~] Debtor is a Transmitting Utility 3
SECURED PARTY SIGNATURE(S)
This statement is filed with only the Secured Party's signature ~o perfect a
security interest in collateral (check applicable box(es)) --
a [~} acquired after a change of name, identity or corporate structure ol the
Debtor.
b. [] as to which the filiug has lapsed.
c. already subject to a security interest in another county in Pennsylvania--
[~ when the collateral was moved to this county.
[] when 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 ibe Debtor's location was moved to Pennsylvania.
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 hnancing statement)
Secured Pert7 Signature(s)
(fequired only if box(es) is checked above):
[] (check only if desired) Products of the collateral are also covered 9
Identify related real estate, if applicable: lbe collateral is, or includes (check appropriate box(esl) --
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. [~] acc~untsresu~tingfr~mthesa~e~fminera~s~rthe~ike~inc~uding~l~andgas)atthewe~lhead~r
m~nehead on --
the tollowing rea) estate:
Street Address:
Described at: 8ook __ Of (check one) [] Deeds [] Mortgages, at Page(s) __
for County Uniform Parcel Identdier ....
[] Described on Additional Sheet
Name of record owner (required only if no DeMur has an interest of record)
~ DEBTOR SIGNATURE(S)
Debtor Stg~tu~eis): / / .4
lb
RETURN RECEIPT TO:
10
11
Northwest Consumer Discount Company
223 Penrose Place
Carlisle Pa 17013
STANDARD FORM -- FORM UCC
F)LING OFFICE ORIGINAL /~l I }~...~
NOTE-THIS PAGE WILL NOT BE RETURNED BY THE DEPARTMENT OF STATE.
IF THE FILING IS WITH THE DEPARTMENT OF STATE, SEND ONLY THIS PAGE,