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2905494-41-2 PANTIES 94758 DANA7 ,L - . .," FINANCING STATEMENT
......... Uniform Commercial Cods Form UCC-I
D;btor nanl~ (last name first if Individual) and mailing address: IM PORTANT-Pleaea read Instructions on
CVS Pharmacy, Inc. reverse side of page 4 before completing
1104 CARLISLE RD Filing No. (stamped by filing etfl~=m'): o;te. Time. Fl~g OIIIc. ($iarn~ed by
CAMP HILL, PA 17011
Debtor Name (last name first if IndMdual) and mailing address:
[] See. rata r/of the Commonwealth.
[] Pro~onota.~ o~ ~ Coun~
[] m~l estate records a~ County
sa~.'.rmS Par~pe.) n~mee(a) (~a*t name erat if ind~dua~! and om~anof S~ee~of Uentmea.o. (~x. 10 Chera~tars): _~ _~@~a.__~a._ a
3404
N.
DUKE
STREET
SEE ATFACHED EXTENSION SHEET FOR A~PRI------------------~PRIA~;=
DURHAM, NC 27704 2 STATEMENT OF COLLATERAL. [-~= .
Asslg .needs) of ~eeursd Part~ name(e) (last name flint If Fs ~ t -
IndMdual) and addre~ for aKurl~ Intamt Iof~rmatlo~: -~"
.~. ¢.~, ..
~-A
~eclal ~ of Parties (cheek If applicable): [ 0 - -
'C~XlaiGI1 ~.' respectively, i.~mYC~N~ Orogdno or to be Orovm on.
SECURED PANTY SIGNATURE(S)
,~ ~. Descdhed at: Book of (check one)l~ Deeds [] Mortgages. at Page(s)
Name of record owner (required rally If no debtor has an Intarset of re~ord):
a~ c~,nty DEBTOR SIGNATURE(8)
[] ~,. ~a =,.~. ~,~ ,.o..d ~o .*n.,~,~.= CVS Pharmacy, Inc.
~lt~ed ~1 Ihe ~lml fl~lnc~g Sla~lm~t) ATFORNEY-IN-FACT
RETURN RECEIPT TO:
· e~ured Parbj ~lgnature(a)
(required only if box(es) is checked above): UCC Direct Services
P.O. Box 29071 ·
QUALEX INC. Glendale
CA ~... (800) 331-3282
91209-9071 ~. (818) 662-4141
.... .' . 2905494-41-2
EXTENSION SHEET FOR UNIFORM COMMERCIAL CODE FINANCING STATEMENTS
STATE OF Pennsylvania
Debtor Secured Party
CVS Pharmacy, Inc. QUALEX INC.
1104 CARLISLE RD 3404 N. DUKE STREET
CAMP HILL, PA 17011
DURHAM, NC 27704
One(l) APS Kit wherever located and including all parts, accessories, ~dditions, attachments, alterations, substitutions,
modifications, and replacements thereof and all proceeds of the foregoing. Nothing in the manner of preparation of this description of
the COLLATERAL which wa~ preparat~ for UNIFORM COMMERCIAL coee filirig offices whera it might conceivably need to be filed,
bnd nothing in its filing in all such places shall create any implication of any sort whatsoever. Further, the parties state that the LEASE
is, and is intended to be, a ~'ue leaso by LESSOR to LESSEE and is not, and is not intended to be, a security agreement ora lease In
the nature of a security interest. This FINANCING STATEMENT is filed solely to pmtoct against the possibility of ti being determined
/.,..~at the LEASE is a security agreement. See attached Schedule A for additional locations. LEASE # ESF
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A'I-FORNEY-IN-FACT A'I-rORNEY-IN-FACT
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