Multi-Purpose Balance Sheet Page 2

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SCHEDULES
(Attach additional pages as necessary)
Instructions: Please complete the schedules first then transfer the totals to page one of the balance sheets.
SCHEDULE A: CASH (CHECKING, SAVINGS, CD, ETC.)
NATURE OF ACCOUNT
NAME OF BANK
LOCATION/BRANCH
BALANCE
(CHECKING, SAVINGS, CD, ETC.)
TOTAL
SCHEDULE B: CASH EQUIVALENTS (MARKETABLE SECURITIES, STOCKS, BONDS, IRA, ETC.)
LOWER OF COST
DESCRIPTION
ORIGINAL PRICE
MARKET VALUE
OR MARKET VALUE
TOTAL
SCHEDULE C: INVESTMENTS (NON-MARKETABLE STOCKS & INVESTMENTS, INVESTMENTS IN OTHER COMPANIES, ETC.)
LOWER OF COST
DESCRIPTION
ORIGINAL PRICE
MARKET VALUE
OR MARKET VALUE
TOTAL
Page 2 of 8
PWF-104 Balance Sheet Revised 4/14/11

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