Form I - Financial Information Page 6

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RRSPs
Financial institution, date of valuation
Value
Financial Assets
Bonds, shares, term deposits, investment certificates, mutual funds – list type,
Value
name of financial institution, when purchased
Accounts
Bank or other accounts – type of account, name of financial institution
Value
Business
Name of business, address, nature and extent of ownership or interest
Value of
Interest
Life Insurance
Company which issued policy
Cash Value
Debts owed to me
Description – name of person owing me money, reason for debt, repayment date
Value
Other
Description of other asset(s)
Value
TOTAL VALUE OF ASSETS
$0.00
Form I
Financial Statement
Page 6

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