Financial Information

Cash in savings account  ______

Stocks and Bonds             ______

IRAs, 401(k), etc.               ______

Cash from - life insurance ______

Real estate, home              ______

Real estate, other              ______

Automobile (s)                   ______

Your own business          ______

Appraised collectibles    ______

Money due you               ______

Other assets (describe)  ______

Total Dollars     ________      

      To Banks                   ______

      To Finance Cos.         ______

Real Estate Indebtedness______

Auto Indebtedness          ______

Owing on life Insurance  ______

Charge Accounts             ______

Credit Cards                      _____

Taxes Payable                  ______

Other Liabilities (describe   

______________          _______

______________          _______

______________          _______

Total Dollars                ________

NET WORTH (Total Assets minus Total Liabilities) _______