| Details |
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| ASSETS - Details |
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| Notes and contracts held |
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| From Whom Owing |
Original Amount |
Original Date |
Monthly Payment |
Maturity Date |
History / Purpose |
Balance Owing |
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$- |
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$- |
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$- |
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| Total |
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- |
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| Securities: stocks / bonds / mutual funds |
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| Name of Security |
Number of Shares |
Cost |
Date of Acquisition |
Market Value |
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$- |
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$- |
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| Total |
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- |
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| Stock in privately held companies |
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| Company Name |
No. of shares |
$ Invested |
Est. Market Value |
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$- |
$- |
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| Total |
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- |
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| Real Estate |
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| Description / Location |
Amount Owing |
Original Cost |
Purchase Date |
Market Value |
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$- |
$- |
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$- |
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| Total |
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- |
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| LIABILITIES |
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| Credit card & charge card debt |
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| Name of Card / Creditor |
Amount Due |
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$- |
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| Total |
- |
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| Notes payable (excluding monthly bills) |
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| Name of Creditor |
Original Amount |
Monthly Payment |
Interest Rate |
Secured by (Leine) |
Amount Owing |
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$- |
$- |
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$- |
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| Total |
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- |
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| Mortgage / real estate loans payable |
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| Name of Creditor |
Original Amount |
Monthly Payment |
Interest Rate |
Secured by (Leine) |
Amount Owing |
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$- |
$- |
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$- |
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| Total |
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- |
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