HomeMy WebLinkAbout01-3527 PARTIES FINANCING STAITMENT
Uniform Comroercial Code torte UCC-
Debter narD& (last name first ifl~...,vindividual) and mailing address: IMPORTANT-Please read instrlrotJona on
S'touf fer,
Jet fG,l~ L. reverse aide of page 4 before completing
1069 Country Club Road Filing No. (stAmped by filing officer): Dote, Time, Filing Office (stamped by filing office-~}:
Camp Hill, PA. 170~1
Debtor norge (last name first if individual) and mailing address: ~
? *'~, ~-,.~_ . -!,
' ' '"Si:' I §
la This Financing Statement i~ presented for Idmg pu,suant ~i~e: Unilo/~% Comn:qje~ll~l Code.
Debtor onroe (last name first if individual) and mailing address: and ,s LO be filed w~lh the (check apphcahle ho~) ~-: ~_.' :.. ~ <..
:~ -' ' i': ·
i-I Secretary of the Commeevvea§h. ~ 5': .-:' '""'
[] Prethonolery of :.-~ . :~-' County.
[] real estate records of ;-=, :~' County,
6
11 re.mi.n, of Addhinnml Rk~ (if a,y): I 7
· ~,~;~ Party(ice) ,.......(s) (last game §ret if individual) and address Optional Special Idontificotion (Max. 10 characters): 8
~0r security interest info~matioo: COLLATERAL
Midwest Capital Group, ThC. Identify collateral by itAm and/ar type:
10 Bow Lane
Barrington Hills. IL. 60010
2
Assignon(s) of Sonured Party naroe(s) (last name firct if individuaf) and SEE ATTACHMI~'.NT "A"
address for security interest infecme§ou:
Kislak National Bank
7900 Miami Lakes Drive West
Miami Lakes, FL. 33016 28
Special Types of Parties (check if applicohle):
[] ~e terms "Debtor" and "Secured Party" moon "Lessee" and "Lessor."
respectively. [] (check only if desired) Products of the collateral ore also covered. 9
[] ]'he terms "OehteF and "Secured Party" moan "Cousignec" and Identify related real estate, if applicable: ]'he collateral is, or includes (check appropriate box(es))-
"Consignor,' respectively.
o. [] crops growing or to he grown on -
[] gte~or is o ]'rousmKtfng Utility. b. [] goods which are or are to become fixtures on -
c. [] minerals or the like (including oiJ add gas) as 9xtrected oo -
d [] accounts ragu(ting from tho sale of miRerele or the like (iecluding oil Dud gas) at the wellhead
SECURED PARTY SIGNATURE(S} minehead ou -
1his statement is filed with only the $ecor~ Party's signature Io pgilect tho following real estate:
a security interest iR c0galerel (check applicable hex(es))- ~trce~ Address:
a. [] acquired after a chuo0e of Dome. ;dent.fy o, co~orste structure o! Described at. Book __ et (check ORe) [] Deeds [] ~lortgogos, at Page(s)
the Debtor. For COURty Umfmm Parcel IdeRtifier
b. [] as to which tho filing has lapsed. [] Deec~ihed on Addihoool Sheet.
c. already subiect to o seourily ioterest io ooothor couoty in Pennsylvania- Norge of record owner (required only if no Dobtm has afl interest of record).
[]when the collateral was moved to this county, f I'
[]when the Debter's residence or place of business was moved to DEBTOR SIGNATURE(G)
this county.
d. already subject tea security interest in another jurisdiction-
[]when the collateral was moved to Pennsylvania.
[]when the Debtor's leca§on was moved to Pennsylvania.
e. [] whicl~ is proceeds of the cogateral deecriped in blouk 9, in which a
secor~ty mteresl was previously perfected (also describe proceeds in la
block 9, if purchased with cash proceeds and not adequately
described on the original financing statement), lb 11
RETURN R,'Ccil'i TO:
SecoredPletySignotura(o) Loan Operations -Kim Yanez
Imquimd ooly if box{es) is checked above): ~ Kislak Nationa1 Bank
7900 Miami Lakes Drive West
Miami Lakes, FL. 33016
STANDARD FORM - FORM UCC- 1 (7-69) -
NOTE - This page will not be returned rtroent of State.
(1) FILING OFFICE ORIGINA/. (6,.'~ ,,~.~
ATTACHMENT "A"
to UCC-I
Between
STOUFFER. JEFFREY L.
DBA MERCANTILE CAPITAL GROUP
("DEBTOR")
and
MIDWEST CAPITAL GROUP, INC.
("SECURED PARTY")
and
KISLAK NATIONAL BANK
("ASSIGNEE")
All capitalized terms are defined in the Master Pumhase Agreement between Debtor and Secured
All of Debtor's right, title, and interest in and to: (i) leased Pentax and Sony videoscope
hardware installed at Naval Hospital, 100 Brewster Blvd., Camp Lejeune, NC 28547-2538, and
Assigned Lease Payments described in Delivery Order No. M670010C0004 dated April 2, 2001,
as amended, between Jeffrey L. Stouffer DBA Mercantile Capital Group and the Conlracting
Division, Camp Lejeune, including all renewal orders for Assigned Lease Payments; (ii) Master
Purchase Agreement F00729 between Debtor and Mercantile Capital Group dated May 15, 2001
and all Purchase Documents thereunder related to the Assigned Lease Payments; and (iii) all
proceeds of any of the foregoing, including, without limitation, termination payments, purchase
option payments, discounted balance or similar payments, and insurance proceeds, in whatever
form received whether cash or non-cash proceeds.
Item Description Otmntirv Serial Numbers
Pentax EG-2931 video gastroscope 4 El 1387, El 1389. El 1390, El 1393
Pentax EC-3830TL video colonoscope 4 El 1824, E11825, E11826, El 1827
Pentax ES-3831 video sigmoidoscope 4 E01059, E01087, E01088. E01092
Pentax ED-3440T video duodenoscope I Al 1437
Pentax EPM-3500 video processor 2 UA01438, UA01448
Pentax EB-1530T3 video bronchoscope 2 E11404, El 1408