Form Ia 6251b - Balance Sheet/statement Of Net Worth - 2011 Page 2

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IA 6251B Instructions
10. Other Personal Property
Include the following:
Complete each section as follows. Be sure to include
the personal and business assets and liabilities of both
the current market value of all household
spouses. IA 6251 should be completed by those
appliances, such as washer, dryer, refrigerator,
eliminating the distressed sale transaction from net
television, stereo, stove, etc.
income and those limiting their tax liability to their net
the current market value of all furniture, such as
worth.
beds, dressers, sofa, chairs, dining room set,
antiques, etc.
Note: The balance sheet should be completed on the
the current market value of all kitchen items,
basis of the accounting method used by the taxpayer.
such as silverware, coffee maker, china, pots
PART A: ASSETS
and pans, etc.
1. Total Cash
the current market value of all other household
Include the balance of your cash accounts, both
items, such as paintings, pictures, musical
personal and business, such as:
instruments, firearms, jewelry, collectibles, etc.
checking accounts
11. TOTAL ASSETS:
savings accounts
Add lines 1 through 10 and enter your total assets
certificate of deposit accounts
on line 11.
credit union accounts
PART B: LIABILITIES
2. Securities
12. Current Liabilities
Include the current value of all your stocks, bonds,
Include the current balance of all your accounts
notes, etc.
owed, both personal and business, such as:
3. Pensions, IRAs, and Social Security Benefits
bank card account balances
Include the current value of the following:
gasoline credit card balances
pensions
other charge card balances
annuities
other credit or installment balances
individual retirement accounts
the total of any loans (insurance loans, vehicle
Social Security benefits
loans, loans for seed, fertilizer, supplies, etc.)
Railroad Retirement benefits
charges for dental or medical care
4. Insurance Policies
13. Long-Term Liabilities
Include the current value of all life insurance
Include the following:
policies.
real estate transactions
5. Accounts Receivable
mortgages
installment obligations
Include the total of any money due you, both
long-term loans (over one year)
personal and business.
14. Accrued Taxes
6. Inventory, Crops, and Livestock.
15. TOTAL LIABILITIES
Include the market value of all your inventory,
crops, livestock, other farm animals, and poultry.
Add lines 12 through 14 and enter your total
liabilities on line 15.
7. Real Property
PART C: NET WORTH
Include the market value of any real estate, both
personal and business.
Subtract your total liabilities, line 15, from your
total assets, line 11, and enter the difference as your
8. Machinery and Equipment
net worth on line 16.
Include the market value of all machinery and
PART D: DEBT TO ASSET RATIO
equipment.
Divide your total liabilities, line 15, by your total
9. Vehicles
assets, line 11, and enter your debt to asset ratio on
Include the current retail value of all vehicles.
line 17.
Include all cars, trucks, recreational vehicles,
motorcycles, etc.
41-135b (07/27/09)

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