Sec Form 1a Regulation A Offering Statement Page 4
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29Financial Statements
Industry Group (select one):
Banking
Insurance
Other
Use the financial statements for the most recent fiscal period contained in this offering statement to provide the
following information about the issuer. The following table does not include all of the line items from the finan-
cial statements. Long Term Debt would include notes payable, bonds, mortgages, and similar obligations. To
determine “Total Revenues” for all companies selecting “Other” for their industry group, refer to Article 5-03(b)
(1) of Regulation S-X. For companies selecting “Insurance,” refer to Article 7-04 of Regulation S-X for calcu-
lation of “Total Revenues” and paragraphs 5 and 7(a) for “Costs and Expenses Applicable to Revenues”.
[If “Other” is selected, display the following options in the Financial Statements table:]
Balance Sheet Information
Cash and Cash Equivalents:
__________________________________
Investment Securities:
__________________________________
Accounts and Notes Receivable:
__________________________________
Property, Plant and Equipment (PP&E):
__________________________________
Total Assets:
__________________________________
Accounts Payable and Accrued Liabilities:
__________________________________
Long Term Debt:
__________________________________
Total Liabilities:
__________________________________
Total Stockholders’ Equity:
__________________________________
Total Liabilities and Equity:
__________________________________
Income Statement Information
Total Revenues:
__________________________________
Costs and Expenses Applicable to Revenues:
__________________________________
Depreciation and Amortization:
__________________________________
Net Income:
__________________________________
Earnings Per Share – Basic:
__________________________________
Earnings Per Share – Diluted:
__________________________________
[If “Banking” is selected, display the following options in the Financial Statements table:]
Balance Sheet Information
Cash and Cash Equivalents:
__________________________________
Investment Securities:
__________________________________
Loans:
__________________________________
Property and Equipment:
__________________________________
Total Assets:
__________________________________
Accounts Payable and Accrued Liabilities:
__________________________________
Deposits:
__________________________________
Long Term Debt:
__________________________________
Total Liabilities:
__________________________________
Total Stockholders’ Equity:
__________________________________
Total Liabilities and Equity:
__________________________________
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