Business Financial Statement Form And Balance Sheet

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BUSINESS FINANCIAL STATEMENT
of
COMPANY NAME ____________________________________________________ DATE______________________
ADDRESS _______________________________________________________________________________________
CITY _______________________________________________ STATE ________________ ZIP _________________
TELEPHONE # ________________________________________ FAX # ____________________________________
EMAIL ADDRESS ______________________________________ WEBSITE _________________________________
BALANCE SHEET
ASSETS
LIABILITIES
Cash in banks.....………………………..............$ _______________ Accounts payable ....................... $ ___________________
Cash on hand..........………………………..........$ _______________ Notes payable on merchandise... $ ___________________
Accounts receivable……………………….........$ _______________ Other notes payable......................$ ___________________
Notes receivable......……………………….........$ _______________ Borrowed from banks-secured ... $ ___________________
A/R & N/R from officers,
Borrowed from banks-unsecured..$ ___________________
partners, & employees …………………….....$ _______________ …………………………………….. . $ ___________________
Inventory/ Merchandise ..........………………....$ _______________ Income Taxes Due
)……………………….....$ _______________
Due on last year's profits ........ $ ___________________
Real estate (from next page
Machinery/Tools/Furniture/Fixtures …………...$ _______________
Due on current year's profits.. $
A/R & N/R from affiliated companies ..………..$ _______________ Other accruals ............................. $ ___________________
Autos.............................................. .........………$ _______________ . .................................................. . ___________________
........................................................ .………........$ _______________ R.E. mortgages (from next page). $ ___________________
........................................................ ……….........$ _______________ Other mortgages (on what?) ....... $ ___________________
........................................................ ……............$ _______________ . ..........................................…...... $ ___________________
......................................................……… ...........$ _______________ . ................................................... $ ___________________
....................................................………..............$ _______________ . ..........................................…..... $ ___________________
.....................................................………. ...........$ _______________ TOTAL LIABILITIES ......…...... $ ___________________
....................................................……….. ...........$ _______________
CAPITAL / EQUITY
Retained Earnings..............…...... $ ___________________
Current Earnings ...........….......... $ ___________________
Common Stock………………….$____________________
…………………………………. $____________________
…………………….…………….$____________________
………………………….……….$____________________
TOTAL CAPITAL ..................... $ ___________________
TOTAL ASSETS...........................………..........$ _______________TOTAL LIABILITIES AND CAPITAL. $ ________________
(Must ASSETS MUST EQUAL COMBINED TOTAL OF LIABILITIES PLUS CAPITAL)
___________________________________________________________________________________________________
SEND TO:
MOBILE INSURANCE AGENCY OF TEXAS, INC.
TEL.# (281) 367-9266
2203 TIMBERLOCH, SUITE 110
FAX # (281) 292-7429
THE WOODLANDS, TX 77380
EMAIL:

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