Sec Form 1a Regulation A Offering Statement Page 5
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29Income Statement Information
Total Interest Income:
_______________________________
Total Interest Expense:
_______________________________
Depreciation and Amortization:
_______________________________
Net Income:
_______________________________
Earnings Per Share – Basic:
_______________________________
Earnings Per Share – Diluted:
_______________________________
[If “Insurance” is selected, display the following options in the Financial Statements table:]
Balance Sheet Information
Cash and Cash Equivalents:
_______________________________
Total Investments:
_______________________________
Accounts and Notes Receivable:
_______________________________
Property and Equipment:
_______________________________
Total Assets:
_______________________________
Accounts Payable and Accrued Liabilities:
_______________________________
Policy Liabilities and Accruals:
_______________________________
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:
_______________________________
[End of section that varies based on the selection of Industry Group]
Name of Auditor (if any): __________________________________________________________
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