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Form Sba Form 413 - Personal Financial Statement/adjusted Personal Net Worth Worksheet Page 5

ADJUSTED PERSONAL NET WORTH WORKSHEET

To determine the economic disadvantage eligibility of an applicant, the Personal Net Worth will be adjusted by the

following to obtain an Adjusted Net Worth total. The Adjusted Net Worth excludes an individual’s equity in his or

her primary residence and it excludes his or her ownership interest in the applicant firm. A sample appears below

along with space to calculate the Adjusted Net Worth.

SAMPLE ADJUSTED PERSONAL NET WORTH

Net Worth (From page 1 of the Personal Net Worth Statement)

$780,000.00 +

Less (minus):

‐ Ownership interest in the applicant firm

$150,000.00 ‐

‐ Equity in the primary residence (FMV‐Mortgage Balance)

$130,000.00 ‐

ADJUSTED NET WORTH TOTAL

$500,000.00=

Adjusted Personal Net Worth for

________________________________________________

Print Name

ADJUSTED PERSONAL NET WORTH CALCULATION

(Attach to the Personal Net Worth Statement)

AMOUNT

Net Worth (From page 1 of the Personal Net Worth Statement)

LESS:

— Ownership interest in the applicant firm

— Equity in the primary residence (FMV‐Mortgage Balance)

ADJUSTED NET WORTH TOTAL $

Form Sba Form 413 - Personal Financial Statement/adjusted Personal Net Worth Worksheet Page 5