Form 13 - Financial Statement (Support Claims) Page 5
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8Form 13:
Financial Statement (Support Claims)
(page 5)
Court file number
Address Where Located
1
$
Other Possessions of
Value (e.g.
$
2
computers, jewellery,
collections)
3
$
Type – Issuer – Due Date – Number of Shares
$
1
Investments (e.g.
bonds, shares, term
2
$
deposits and mutual
funds)
3
$
Name and Address of Institution
Account Number
$
1
Bank Accounts
2
$
3
$
Type and Issuer
Account Number
$
1
Savings Plans
R.R.S.P.s
2
$
Pension Plans
R.E.S.P.s
3
$
Type – Beneficiary – Face Amount
Cash Surrender Value
1
$
Life Insurance
2
$
$
3
Name and Address of Business
1
$
Interest in Business
(*attach separate year-
2
$
end statement for each
business)
$
3
Name and Address of Debtors
Money Owed to You
1
$
(for example, any court
2
$
judgments in your
favour, estate money
$
3
and income tax refunds)
Description
1
$
Other Assets
$
2
3
$
Total Value of All Property
$
FLR 13 (February 1, 2010)
Page 5 of 8
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Parent category: Financial