Personal And Financial Information Form Page 4
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2
3
4OTHER ASSETS NOT LISTED:
TYPE
YOU
SPOUSE
JOINT
TOTAL
$
$
$
$
$
$
$
$
$
$
$
$
Total Value
LIABILITIES:
TYPE
YOU
SPOUSE
JOINT
TOTAL
Mortgage
$
$
$
$
Loans Payable
$
$
$
$
Other
$
$
$
$
$
$
$
$
Total Value
BUSINESS INTEREST:
TYPE
YOU
SPOUSE
JOINT
TOTAL
Farm
$
$
$
$
Partnership or LLC Interest
$
$
$
$
Corporation
$
$
$
$
□-Corp?
Other:
$
$
$
$
$
$
$
$
Total Value
Please list supplemental health and prescription drug insurance here: (Company Name & Premium Amount)
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_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
Notes/Comments:
__________________________________________________________________________________________________________________________
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S:\FORMS\ESTATE PLANNING\PERSONAL AND FINANCIAL INFORMATION SHEET 2.RTF
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