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<br /> , ` Thlc STATE�.tEf�T is proeen�od�o a Iil�nq ollicot(or IiUnp pu�wmi��o�ho Unilwrm Commardal Codo� 3.1Ao�url�y doto(11 any)i G'�""4'°7j � � -
<br /> �. � 1,Oohtor��) (Loof Namo F�rar)und oddrots(oe) 2.S.�eurod ParryUoe)and oddro�e(o�) For Fllinp Oflicm(Ooto� 7�no and Filfnp I �! ^ „ -
<br /> �6lC�e! �.�11C�=11 011icol •
<br /> ro��n� Gca�n�y F�anls � ". .
<br /> � NLiC}i�� Pr1�''�t"Fi�u BU E3QX JSfS�J /' "v'•'i°Gr;,• i
<br /> F'�"i L Boic 6� ttcnc�acr� N� 6n9so ��`° �.����jy�;�.�9' '
<br /> Eiall Coe► Kone�gzrr � 6895& . ' _
<br /> • ,, socin► socur�ty No.-ufl�72�?5�l3 Foaaral I.o.No. ���9��Q ' T
<br /> =" � „ �-�'i��b���_ . _ . . .. _ __.— ._ -
<br /> - . . d.Thie t�otomen�rolm� �o onp�nol Finonc��p Srmemon�boormp F�lo No. q���.�1�Q� �� ..
<br /> . Fllod rirh � �g �'�'a`J Octt F�lod �"2�. 19�� ., ,
<br /> -- : .. � . 5.��Cn11nu0flon. The onfl�nal I�naneinp ��mamen�boewoan tho lorngoinq Dobior und$oeurad Perty,boannp(ilo numbor shown abov��1�a1111 e(latliv�. " � � �
<br />_ ' . . -� 6.�TErtnittaNOn. Socurod porry no lonpor claimt n wcvnry �nwros�unde�tho 6nannnfl ucromen�bom�np hle numbor thown abova. . ^ . ..
<br /> : 7.QA7tl�manf, Ttie weurod po��y���iphf undae �ho Imanc�ng►rotemoni beonnp filo numbor �hown obo•o�o�ho properry doseribed In Ifem 10 havs -
<br /> been n��i,7nod eo rl+e aa��pneo who�e namo ond addroei appeot�in Item 10.
<br /> � O,QA�nt.�dmrnt. F�nanalnp Sraromont beorinp hlo n�mburshown abovo��omended ns tor(orth in Ifem 10. -� "� �
<br />- ' 9.�fZolOOSO. Soc�rod Parry relooso�thu collnroral do�u�6ed in I�om 10 from tho Ilnanc�nq statomcnf 600rinp Alo wmbor�hawn abo•ie. '; � .
<br /> - �o.SE; SeG 35-�9-12 . _. � .
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<br /> , No.o(add�t�o�nl Sh�ots pre�eneed: ^f , �
<br /> - � . . �_��, �n��n�.s A�n� � .. 1 � .
<br /> , byi br� —
<br />_- $iqnoturo(s)of Debtor(s)Inecessary only i( I�em 8�ti appl�ceble). nutur s o ee�red ParrY(ies) .
<br /> - (i)FOLING OFFICC•C!COPV • 1�4P64ADETICAL
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