FINANCING STATEMENT
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Debtor (Last Name First/Individual)   Social Security Number
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Mailing Address              City, State            Zip Code
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Additional Debtor - (If Any)          Social Security Number
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Mailing Address              City, State            Zip Code
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Debtor's Trade Names or Styles            Federal Tax Number
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Secured Party                            Social Security No.
Name                                     Federal Tax No. or
Address                                  Bank Transit and
City, State                              A.B.A. No.
Zip Code
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Assignee of Secured Party                Social Security No.
Name                                     Federal Tax No. or
Address                                  Bank Transit and
City, State                              A.B.A. No.
Zip Code
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This FINANCING STATEMENT covers the following types or
items of property (include description of real property
on which located and owner of record when required).

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Products of Collateral are also covered Yes______No______
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Debtor is a "Transmitting Utility"      Yes______No______
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                                             Date:
Signature(s) of Debtor(s)
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Type or Print Name of Debtor
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Signature(s) of Secured Party(ies)
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Type or Print Name of Secured Party
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Return Copy to:

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