Dissolution (Divorce) Intake Form Page 8

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Business and Farm Assets
Name of Business: _________________________________________________________________________________
Address: _____________________________________________________________________________________________
Type of Business: __________________________________________________________________________________
Approximate Value of Business: _________________________________
Name of Person Operating Business: _____________________________________________________
If farm property, please provide list of machinery, crops, leases, etc. and approximate
value.
Cash and Bank Accounts
Name of Bank: ________________________________________________
Type of Account: ____________________________________ Balance: __________________________________
Name(s) on the Account: _________________________________________________________________________
Account Number: _________________________________ P.O.D.? ______________________________________
Name of Bank: ________________________________________________
Type of Account: ____________________________________ Balance: __________________________________
Name(s) on the Account: _________________________________________________________________________
Account Number: _________________________________ P.O.D.? ______________________________________
Name of Bank: ________________________________________________
Type of Account: ____________________________________ Balance: __________________________________
Name(s) on the Account: _________________________________________________________________________
Account Number: _________________________________ P.O.D.? ______________________________________

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Parent category: Business